Microplastics in the environment: An urgent need for coordinated waste management policies and strategies.

Microplastics (MPs) have become a prevalent environmental concern, exerting detrimental effects on marine and terrestrial ecosystems, as well as human health. Addressing this urgent issue necessitates the implementation of coordinated waste management policies and strategies. In this study, we present a comprehensive review focusing on key results and the underlying mechanisms associated with microplastics. We examine their sources and pathways, elucidate their ecological and human health impacts, and evaluate the current state of waste management policies. By drawing upon recent research and pertinent case studies, we propose a range of practical solutions, encompassing enhanced recycling and waste reduction measures, product redesign, and innovative technological interventions. Moreover, we emphasize the imperative for collaboration and cooperation across sectors and jurisdictions to effectively tackle this pressing environmental challenge. The findings of this study contribute to the broader understanding of microplastics and provide valuable insights for policymakers, researchers, and stakeholders alike.

Optimizing MWCNT-Based Nanofluids for Photovoltaic/Thermal Cooling through Preparation Parameters.

Multiwalled carbon nanotubes (MWCNTs) were employed as added particles for nanofluids in this practical investigation. To identify the most appropriate nanofluid for cooling PVT systems that are functional in the extreme summer environment of Baghdad, the parameters of base fluid, surfactant, and sonication time used for mixing were examined. Water was chosen as the base fluid instead of other potential candidates such as ethylene glycol (EG), propylene glycol (PG), and heat transfer oil (HTO). Thermal conductivity and stability were important thermophysical qualities that were impacted by the chosen parameters. The nanofluid tested in Baghdad city (consisting of 0.5% MWCNTs, water, and CTAB with a sonication period of three and a quarter hours) resulted in a 119.5, 308, and 210% enhancement of thermal conductivity (TC) for water compared with EG, PG, and oil, respectively. In addition, the nanofluid-cooled PVT system had an electrical efficiency that was 88.85% higher than standalone PV technology and 44% higher than water-cooled PVT systems. Moreover, the thermal efficiency of the nanofluid-cooled PVT system was 20% higher than the water-cooled PVT system. Finally, the nanofluid-cooled PVT system displayed the least decrease in electrical efficiency and a greater thermal efficiency even when the PV panel was at its hottest at noon.

Surgical Anatomy of Vertebral Artery in Relation to Atlantoaxial Instrumentation: A Cadaveric Study.

BACKGROUND: With the advent of pedicle screws and advanced instrumentation techniques, internal fixation and stabilization of upper cervical vertebrae are possible in fractures of an axis. However, the proximity of vertebral arteries (VAs) poses a unique challenge to surgeons during these procedures and can result in profound physical impairment to patients. Cadaveric studies contributing to fine anatomical details necessitate conducting such studies. METHODS: After receiving due ethical permission, this descriptive cross-sectional study was carried out on 10 cadavers in the department of Anatomy, All India Institute of Medical Science (AIIMS) Rishikesh. Twenty VAs were dissected along their course, and measurements of parameters related to the axis and atlas vertebra were noted. RESULTS: The length of the pre-osseous segment related to the axis (VAX-1) on the right and left sides were from 3.8 to 14.5 mm (7.48±3.88 mm) and 4.46 to 10.5mm (6.94±2.01mm) respectively. The length of the osseous segment related to the axis (VAX-2) on the right side and left sides were from 6.82 to 31 mm (17.9±7.84mm) and 7.35 to 20 mm (15.6±4.53). The osseous segment of the VA related to the axis (VAX-2) shows genu (bend), which extends to a variable distance towards the midline. The mean distance of VA genu from the midline of the axis vertebral body on the right and left sides was 15.6mm and 17.5 mm, respectively. The percentage of superior articular facet (SAF) surface area of the axis occupied by the VA was 25-50% in nine and 50-75% in 11 cadavers, reflecting incomplete occupancy. CONCLUSION: The study suggests that for instrumentation of the axis vertebra in the midline, the minimum distance between the genu of both sides of VA segments, related to an osseous segment of the axis (VAX-2) and medial extent of the VA groove of the atlas, should be considered as a safe zone to minimize inadvertent VA injury. During atlantoaxial fixation through a posterior approach in interarticular, pars, and pedicle screws, the surgical anatomy of the VA in relation to the osseous segment of the VA within the transverse process of the axis should be kept in mind to avoid inadvertent VA injury.

Complete genome sequence of Bacillus Licheniformis NWMCC0046, a candidate for the laundry industry.

In this study, selected properties of protease and the complete genome sequence of Bacillus licheniformis NWMCC0046 were investigated, to discover laundry applications and other potential probiotic properties of this strain. Partial characterization of B. licheniformis NWMCC0046 showed that its protease has good activity both in alkaline environments and at low temperatures. Also, the protease is compatible with commercial detergents and can be used as a detergent additive for effective stain removal at low temperatures. The complete genome sequence of B. licheniformis NWMCC0046 is comprised of a 4,321,565 bp linear chromosome with a G + C content of 46.78% and no plasmids. It had 4504 protein-encoding genes, 81 transfer RNA (tRNA) genes, and 24 ribosomal RNA (rRNA) genes. Genomic analysis revealed genes involved in exocellular enzyme production and probiotic properties. In addition, genomic sequence analysis revealed specific genes encoding carbohydrate metabolism pathways, resistance, and cold adaptation capacity. Overall, protease properties show its potential as a detergent additive enzyme. The complete genome sequence information of B. licheniformis NWMCC0046 was obtained, and functional prediction revealed its numerous probiotic properties.

Tobacco cessation by prescription - A 180 degree turn.

Utilisation of tobacco is one of the most serious problems affecting human health worldwide, despite the fact that the early fatality caused by tobacco use are growing, regardless of the fact that it is avoidable tobacco consumption is very common, considerable resources have been allocated to this issue. On tobacco prevention, a range of strategies have been tested but the ratio of death due to tobacco and number of tobacco consumers is increasing day by day. Various impediments to tobacco quitting have been recognized, all of which contribute to the failure of various tobacco cessation programs and methodologies. Individuals in the India have attempted or considered quitting smoking at some point in their lives but ended in failure. Existing tobacco cessation programs have not out-turned in a decrease in the figure of tobacco users or deaths, necessitating a new strategy. Tobacco cessation on prescription, developed from physical activity on prescription (PAP), can be a useful method in terms of public health. But yet no studies have ever been conducted over this. Further studies on this can explore results of tobacco quitting after prescription from general physician or other medical practitioner, evaluative beliefs about tobacco consumption and barriers in quitting even after prescription. Hence the present review was done with explore the outcomes for cessation of tobacco based upon utilization of tobacco cessation by prescription (TCP) methodology in Indian scenario. This review paper focuses on TCP as a need for newer approach pertaining to Indian perspective. Future study should look at whether raising the rate of stop attempts are improving the tobacco cessation rate in the general population after the implementation of TCP.

Understanding the role of glycation in the pathology of various non-communicable diseases along with novel therapeutic strategies.

Glycation refers to carbonyl group condensation of the reducing sugar with the free amino group of protein, which forms Amadori products and advanced glycation end products (AGEs). These AGEs alter protein structure and function by configuring a negative charge on the positively charged arginine and lysine residues. Glycation plays a vital role in the pathogenesis of metabolic diseases, brain disorders, aging, and gut microbiome dysregulation with the aid of 3 mechanisms: (i) formation of highly reactive metabolic pathway-derived intermediates, which directly affect protein function in cells, (ii) the interaction of AGEs with its associated receptors to create oxidative stress causing the activation of transcription factor NF-κB, and (iii) production of extracellular AGEs hinders interactions between cellular and matrix molecules affecting vascular and neural genesis. Therapeutic strategies are thus required to inhibit glycation at different steps, such as blocking amino and carbonyl groups, Amadori products, AGEs-RAGE interactions, chelating transition metals, scavenging free radicals, and breaking crosslinks formed by AGEs. The present review focused on explicitly elaborating the impact of glycation-influenced molecular mechanisms in developing and treating noncommunicable diseases.

Corrosion Inhibition of Mild Steel in Hydrochloric Acid Environment Using Terephthaldehyde Based on Schiff Base: Gravimetric, Thermodynamic, and Computational Studies.

Using traditional weight-loss tests, as well as different electrochemical techniques (potentiodynamic polarization and electrochemical impedance spectroscopy), we investigated the corrosion-inhibition performance of 2,2'-(1,4-phenylenebis(methanylylidene)) bis(N-(3-methoxyphenyl) hydrazinecarbothioamide) (PMBMH) as an inhibitor for mild steel in a 1 M hydrochloric acid solution. The maximum protection efficacy of 0.0005 M of PMBMH was 95%. Due to the creation of a protective adsorption layer instead of the adsorbed H2O molecules and acidic chloride ions, the existence of the investigated inhibitor reduced the corrosion rate and increased the inhibitory efficacy. The inhibition efficiency increased as the inhibitor concentration increased, but it decreased as the temperature increased. The PMBMH adsorption mode followed the Langmuir adsorption isotherm, with high adsorption-inhibition activity. Furthermore, the value of the ∆Gadso indicated that PMBMH contributed to the physical and chemical adsorption onto the mild-steel surface. Moreover, density functional theory (DFT) helped in the calculation of the quantum chemical parameters for finding the correlation between the inhibition activity and the molecular structure. The experimental and theoretical findings in this investigation are in good agreement.

Adding Nano-TiO2 to Water and Paraffin to Enhance Total Efficiency of a Photovoltaic Thermal PV/T System Subjected to Harsh Weathers.

Iraq is characterized by hot and sunny weather with high radiation intensity. These conditions are suitable to produce photovoltaic electricity, on the one hand, but on the other hand are not suitable for photovoltaic modules whose efficiency decreases with increasing temperature. In this study, a photovoltaic module was practically cooled by two PV/T systems, one cooled by water and the other by nanofluid and nano-paraffin. Iraqi-produced paraffin was used in this study for its cheap price, and because its melting and freezing temperature (46 °C) is close to the operating range of photovoltaic modules. Nano-TiO2 was adopted as an additive to water and paraffin. The study results showed an obvious enhancement of the thermal conductivity of both water and paraffin, by up to 126.6% and 170%, respectively, after adding a 2% mass fraction of nano-TiO2. The practical experiments were carried out outdoors in the city of Baghdad, Iraq. A fluid mass flow rate of 0.15 kg/s was selected for practical reasons, since at this rate the system operates without vibration. The PV panel's temperature, in the PV/T system (nano-fluid and nano-paraffin), decreased by an average of 19 °C when the tested systems operated during the peak period (12 PM to 3 PM). The decrease in temperatures of the PV module caused a clear improvement in its electrical efficiency, as it was 106.5% and 57.7% higher than the PV module (standalone) and water-cooled PV system, respectively. The thermal efficiency of this system was 43.7% higher than the case of the water-cooled PV/T system. The proposed system (nano-fluid and nano-paraffin) provides a greater possibility of controlling the heat capacity and increasing both efficiencies (electrical and thermal), when compared to a standalone PV module, in harsh Iraqi weather.

Factors Associated With Highest Symptoms of Anxiety During COVID-19: Cross-Cultural Study of 23 Countries.

The COVID-19 restrictions have impacted people's lifestyles in all spheres (social, psychological, political, economic, and others). This study explored which factors affected the level of anxiety during the time of the first wave of COVID-19 and subsequent quarantine in a substantial proportion of 23 countries, included in this study. The data was collected from May to August 2020 (5 June 2020). The sample included 15,375 participants from 23 countries: (seven from Europe: Belarus, Bulgaria, Croatia, Hungary, Italy, Romania, Russia; 11 from West, South and Southeast Asia: Armenia, India, Indonesia, Iran, Iraq, Jordan, Malaysia, Pakistan, Saudi Arabia, Thailand, Turkey; two African: Nigeria and Tanzania; and three from North, South, and Central America: Brazil, Canada, United States). Level of anxiety was measured by means of the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the 20-item first part of The State-Trait Anxiety Inventory (STAI)-State Anxiety Inventory (SAI). Respondents were also asked about their personal experiences with COVID-19, attitudes toward measures introduced by governments, changes in attitudes toward migrants during a pandemic, family income, isolation conditions, etc. The factor analysis revealed that four factors explained 45.08% of variance in increase of anxiety, and these components were interpreted as follows: (1) personal awareness of the threat of COVID-19, (2) personal reaction toward officially undertaken measures and attitudes to foreigners, (3) personal trust in official sources, (4) personal experience with COVID-19. Three out of four factors demonstrated strong associations with both scales of anxiety: high level of anxiety was significantly correlated with high level of personal awareness of the threat of COVID-19, low level of personal reaction toward officially undertaken measures and attitudes to foreigners, and high level of presence of personal experience with COVID-19. Our study revealed significant main effects of sex, country, and all four factors on the level of anxiety. It was demonstrated that countries with higher levels of anxiety assessed the real danger of a pandemic as higher, and had more personal experience with COVID-19. Respondents who trusted the government demonstrated lower levels of anxiety. Finally, foreigners were perceived as the cause of epidemic spread.

Classification of cardiac arrhythmia using a convolutional neural network and bi-directional long short-term memory.

Cardiac arrhythmia is a leading cause of cardiovascular disease, with a high fatality rate worldwide. The timely diagnosis of cardiac arrhythmias, determined by irregular and fast heart rate, may help lower the risk of strokes. Electrocardiogram signals have been widely used to identify arrhythmias due to their non-invasive approach. However, the manual process is error-prone and time-consuming. A better alternative is to utilize deep learning models for early automatic identification of cardiac arrhythmia, thereby enhancing diagnosis and treatment. In this article, a novel deep learning model, combining convolutional neural network and bi-directional long short-term memory, is proposed for arrhythmia classification. Specifically, the classification comprises five different classes: non-ectopic (N), supraventricular ectopic (S), ventricular ectopic (V), fusion (F), and unknown (Q) beats. The proposed model is trained, validated, and tested using MIT-BIH and St-Petersburg data sets separately. Also, the performance was measured in terms of precision, accuracy, recall, specificity, and f1-score. The results show that the proposed model achieves training, validation, and testing accuracies of 100%, 98%, and 98%, respectively with the MIT-BIH data set. Lower accuracies were shown for the St-Petersburg data set. The performance of the proposed model based on the MIT-BIH data set is also compared with the performance of existing models based on the MIT-BIH data set.

Experimental and theoretical study on the corrosion inhibition of mild steel by nonanedioic acid derivative in hydrochloric acid solution.

The corrosion performance of mild steel (MS) in 1M HCl solution was examined by weight loss (WL), potentiodynamic polarization (PDP), electrochemical impedance spectroscopy (EIS), electrochemical frequency modulation (EFM), and open circuit potential (OCP) measurements in the absence and presence of nonanedihydrazide. PDP measurements indicated that nonanedihydrazide acts as a mixed inhibitor due to its adsorption on the MS surface, exhibiting an inhibition efficiency of more than 97%. The surface morphology investigation of the protective layer on the MS surface confirmed that adsorption of nonanedihydrazide molecules occurred via chemical adsorption following Langmuir's isotherm model. The effect of temperature on the corrosion performance in the presence of nonanedihydrazide was investigated in the range of 303-333 K, showing that the inhibition efficiency increased with an increase in the inhibitor concentration and decreased with an increase in temperature. A new green corrosion inhibitor was synthesised and theoretical computations were conducted to completely understand the inhibition mechanism. Nonanedihydrazide molecules were investigated by DFT (density functional theory) using the B3LYP functional to evaluate the relationship of corrosion inhibition performance and the molecular structure. The computed theoretical parameters presented significant support for understanding the inhibitive mechanism revealed by the inhibitory molecules and are in good agreement with WL, PDP, EIS, (EFM), and OCP results.

Comparative data on corrosion protection of mild steel in HCl using two new thiazoles.

This data article includes data described in the investigation report entitled "The synergistic role of azomethine group and triazole ring at improving the anti-corrosive performance of 2-amino-4-phenylthiazole" (Alamiery et al., 2021). In this data article, a comprehensive effect of 2-Amino-4-phenyl-N-benzylidene-5-(1,2,4-triazol-1-yl)thiazole (APNT) and 2-amino-4-phenylthiazole (APT) and optimized process parameter of the inhibitor in 1 M HCl solution was presented using gravimetric techniques and Density functional theory. The presence of the inhibitors influenced the corrosion resistance of mild steel (MS). Inhibition efficiencies values of 98.1% and 94.74% were recorded as results of inhibition of the MS by the inhibiting compounds APNT and ATP respectively. DFT studies observed that the presence of benzylidene to the APNT and the substitution of a triazole in the thiazole ring are adsorption sites that increase the interaction of the APNT molecules with the iron atoms on the MS surface.

Proximate larval epidermal cell layer generates forces for Pupal thorax closure in Drosophila.

During tissue closures, such as embryonic dorsal closure in Drosophila melanogaster, a proximate extra-embryonic layer, amnioserosa, generates forces that drive migration of the flanking lateral embryonic epidermis, thereby zip-shutting the embryo. Arguably, this paradigm of tissue closure is also recapitulated in mammalian wound healing wherein proximate fibroblasts transform into contractile myofibroblasts, develop cell junctions, and form a tissue layer de novo: contraction of the latter then aids in wound closure. Given this parallelism between disparate exemplars, we posit a general principle of tissue closure via proximate cell layer-generated forces. Here, we have tested this hypothesis in pupal thorax closure wherein 2 halves of the presumptive adult thorax of Drosophila, the contralateral heminotal epithelia, migrate over an underlying larval epidermal cell layer. We show that the proximate larval epidermal cell layer promotes thorax closure by its active contraction, orchestrated by its elaborate actomyosin network-driven epithelial cell dynamics, cell delamination, and death-the latter being prefigured by the activation of caspases. Larval epidermal cell dynamics generate contraction forces, which when relayed to the flanking heminota-via their mutual integrin-based adhesions-mediate thorax closure. Compromising any of these contraction force-generating mechanisms in the larval epidermal cell layer slows down heminotal migration, while loss of its relay to the flanking heminota abrogates the thorax closure altogether. Mathematical modeling further reconciles the biophysical underpinning of this emergent mechanism of thorax closure. Revealing mechanism of thorax closure apart, these findings show conservation of an essential principle of a proximate cell layer-driven tissue closure.

Effect of 12 mg vs 6 mg of Dexamethasone on the Number of Days Alive Without Life Support in Adults With COVID-19 and Severe Hypoxemia: The COVID STEROID 2 Randomized Trial.

Importance: A daily dose with 6 mg of dexamethasone is recommended for up to 10 days in patients with severe and critical COVID-19, but a higher dose may benefit those with more severe disease. Objective: To assess the effects of 12 mg/d vs 6 mg/d of dexamethasone in patients with COVID-19 and severe hypoxemia. Design, Setting, and Participants: A multicenter, randomized clinical trial was conducted between August 2020 and May 2021 at 26 hospitals in Europe and India and included 1000 adults with confirmed COVID-19 requiring at least 10 L/min of oxygen or mechanical ventilation. End of 90-day follow-up was on August 19, 2021. Interventions: Patients were randomized 1:1 to 12 mg/d of intravenous dexamethasone (n = 503) or 6 mg/d of intravenous dexamethasone (n = 497) for up to 10 days. Main Outcomes and Measures: The primary outcome was the number of days alive without life support (invasive mechanical ventilation, circulatory support, or kidney replacement therapy) at 28 days and was adjusted for stratification variables. Of the 8 prespecified secondary outcomes, 5 are included in this analysis (the number of days alive without life support at 90 days, the number of days alive out of the hospital at 90 days, mortality at 28 days and at 90 days, and ≥1 serious adverse reactions at 28 days). Results: Of the 1000 randomized patients, 982 were included (median age, 65 [IQR, 55-73] years; 305 [31%] women) and primary outcome data were available for 971 (491 in the 12 mg of dexamethasone group and 480 in the 6 mg of dexamethasone group). The median number of days alive without life support was 22.0 days (IQR, 6.0-28.0 days) in the 12 mg of dexamethasone group and 20.5 days (IQR, 4.0-28.0 days) in the 6 mg of dexamethasone group (adjusted mean difference, 1.3 days [95% CI, 0-2.6 days]; P = .07). Mortality at 28 days was 27.1% in the 12 mg of dexamethasone group vs 32.3% in the 6 mg of dexamethasone group (adjusted relative risk, 0.86 [99% CI, 0.68-1.08]). Mortality at 90 days was 32.0% in the 12 mg of dexamethasone group vs 37.7% in the 6 mg of dexamethasone group (adjusted relative risk, 0.87 [99% CI, 0.70-1.07]). Serious adverse reactions, including septic shock and invasive fungal infections, occurred in 11.3% in the 12 mg of dexamethasone group vs 13.4% in the 6 mg of dexamethasone group (adjusted relative risk, 0.83 [99% CI, 0.54-1.29]). Conclusions and Relevance: Among patients with COVID-19 and severe hypoxemia, 12 mg/d of dexamethasone compared with 6 mg/d of dexamethasone did not result in statistically significantly more days alive without life support at 28 days. However, the trial may have been underpowered to identify a significant difference. Trial Registration: ClinicalTrials.gov Identifier: NCT04509973 and ctri.nic.in Identifier: CTRI/2020/10/028731.

Challenges in the Ethical Review of Clinical and Biomedical Research in Malaysia: A Mixed Methods Study.

Empirical evidence of the ethical review of clinical and biomedical research in Malaysia is limited. We have conducted a convergent mixed methods research, which comprises an online survey and semistructured interviews to examine the challenges in the ethical review of clinical and biomedical research. Data collected reveal that the ethics review process is inconsistent, duplicate, and inadequate. The results indicate a strong need for a centralized ethical review mechanism and a national system for mutual recognition of ethics reviews to improve the effectiveness and efficiency of the ethics review system in Malaysia. A joint research ethics committee review between Malaysia and sponsoring countries for multinational research should also be encouraged as it could address the concerns of the lack of expertise and training.

Antiproliferative Activity of Cissus quadrangularis L. Extract Against Human Cervical Cancer Cells: In Vitro and In Silico Analysis.

BACKGROUND: Cervical cancer is the second leading cause of cancer in women, which necessitates safe and potential therapeutic agents. OBJECTIVE: This study was designed to investigate the antiproliferative effect of ethanolic extract of Cissus quadrangularis L. (CQ) against human cervical adenocarcinoma HeLa cell line and in silico analysis of selected active agents against apoptosis executioner enzyme caspase-3. METHODS: Cell viability was analyzed in HeLa cells at different concentrations (25-300 µg/ml) of CQ extract. Reactive oxygen species (ROS) generation, cellular apoptosis, cell cycle analysis and caspases-3 activation were evaluated. In silico, structure-based virtual screening analysis was carried out using AutoDock Vina and iGEMDOCK. RESULTS: Cell viability of HeLa cells was reduced significantly (p < 0.05) in a dose-dependent manner, however, CQ extract showed non-toxic to normal kidney epithelial NRK-52E cells. CQ extract induced the intracellular ROS level, nuclear condensation and reduced the mitochondrial membrane potential (MMP) with the induction of annexin V-FITC positive cells. CQ extract arrested cells in G0/G1 and G2/M checkpoints and activated caspase-3 activity significantly in HeLa cells. The molecular docking study showed a strong binding affinity of CQ phytocomponents against the caspase-3 (PDB ID: 1GFW) protein of human apoptosis. PASS analyses of selected active components using Lipinski's Rule of five showed promising results. Further, drug-likeness and toxicity assessment using OSIRIS Data Warrior V5.2.1 software exhibited the feasibility of phytocomponents as drug candidates with no predicted toxicity. CONCLUSION: This study suggested that active constituents in CQ extract can be considered as potential chemotherapeutic candidates in the management of cervical cancer.

Manufacture of Contact Lens of Nanoparticle-Doped Polymer Complemented with ZEMAX.

Many people suffer from myopia or hyperopia due to the refractive errors of the cornea all over the world. The use of high refractive index (RI), Abbe number (νd), and visible light transmittance (T%) polymeric contact lenses (CLs) holds great promise in vision error treatment as an alternative solution to the irreversible laser-assisted in situ keratomileusis (LASIK) surgery. Titanium dioxide nanoparticles (TiO2 NPs) have been suggested as a good candidate to rise the RI and maintain high transparency of a poly(methyl methacrylate) (PMMA)-TiO2 nanocomposite. This work includes a preparation of TiO2 NPs using the sol gel method as well as a synthesis of pure PMMA by free radical polarization and PMMA-TiO2 CLs using a cast molding method of 0.005 and 0.01 w/v concentrations and a study of their effect on the aberrated human eye. ZEMAX optical design software was used for eye modeling based on the Liou and Brennan eye model and then the pure and doped CLs were applied. Ocular performance was evaluated by modulation transfer function (MTF), spot diagram, and image simulation. The used criteria show that the best vision correction was obtained by the CL of higher doping content (p < 0.0001) and that the generated spherical and chromatic aberrations in the eye had been reduced.

Adverse pregnancy outcomes among multi-ethnic systemic lupus erythematosus patients in Malaysia.

BACKGROUND: Despite the improvement in the live birth rate among patients with systemic lupus erythematosus (SLE), they are still at an increased risk of adverse pregnancy outcomes (APOs). OBJECTIVE: To determine the prevalence and factors associated with APOs in the multi-ethnic SLE populations in Malaysia.Methodology: This was a retrospective review of the consecutive SLE patients who attended the outpatient clinic in two major rheumatology centres from January 2016 until December 2019 with complete pre-pregnancy, antenatal and intra-partum records. APOs include pregnancy loss, prematurity, pre-eclampsia, intra-uterine growth restriction (IUGR) and maternal death. Univariate and multivariable logistic regression with generalised estimating equation (GEE) analyses were performed to determine the factors associated with APOs. RESULTS: A total of 153 patients with 240 pregnancies were included and the majority of the patients were Malay (69.9%), followed by Chinese (24.2%) and Indian (5.9%). The prevalence of APOs was 61.7% with the commonest complication being prematurity (28.3%), followed by pregnancy loss (24.6%) and pre-eclampsia (21.8%). Logistic regression model-based GEE analysis revealed that the independent predictors of APOs were active haematological system during pregnancy, pre-pregnancy active disease, Indian patients and positive lupus anticoagulant. Hydroxychloroquine use was associated with lower APOs including pre-eclampsia, prematurity and IUGR in the univariate analyses but it was no longer significant in the GEE analysis. CONCLUSION: The prevalence of APOs was high particularly among the Indian patients. Positive lupus anticoagulant and pre-pregnancy active disease were the factors strongly associated with APOs in our multi-ethnic cohort. Hydroxychloroquine may protect against APOs but further larger studies are needed to confirm this.

Cytochrome P450 2A6 whole-gene deletion (CYP2A6*4) polymorphism reduces risk of lung cancer: A meta-analysis.

INTRODUCTION: Lung cancer is the most commonly diagnosed cancer worldwide and is the leading cause of cancer death. Smoking is a major contributor to the pathogenesis of lung cancer. Cytochrome P450 2A6 (CYP2A6) is responsible for the metabolic activation of most tobacco carcinogens. CYP2A6 genetic polymorphism can cause variations in the human metabolism of xenobiotics. We performed this meta-analysis to determine the association between whole-gene CYP2A6 deletion polymorphism (CYP2A6*4) and lung cancer risk. METHODS: The PubMed, SAGE, Science Direct, the Cochrane Library and Ovid databases were searched for observational studies before October 2018. Methodological quality was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). RESULTS: Nine case-control studies involving 4385 lung cancer cases and 4142 controls were included in the analysis. The random-effects model was used to combine results from individual studies. The pooled odds ratio was 0.39 (95% CI: 0.27-0.56). There was no heterogeneity across studies (χ2=2.49, p=0.96, I2=0%). CONCLUSIONS: Current evidence from the case-control studies suggests that the CYP2A6 whole-gene deletion polymorphism decreases the risk of lung cancer. Further research is needed to identify any potential confounding factors that may impact this association.

Effect and safety of gemtuzumab ozogamicin for the treatment of patients with acute myeloid leukaemia: a systematic review protocol.

INTRODUCTION: Acute myeloid leukaemia (AML) is a type of cancer in which the bone marrow makes abnormal myeloblasts (a type of white blood cell), red blood cells or platelets. Gemtuzumab ozogamicin (GO) holds promise as a new agent that also could be efficacious in newly diagnosed AML with acceptable toxicity. This paper describes the design of a protocol to conduct a systematic review of published studies assessing GO for the treatment of AML. METHOD AND ANALYSIS: We will conduct a systematic review of randomised controlled trials that investigate the effect and safety of GO for the treatment of patients with AML. We will search for any eligible articles from selected electronic databases. We will follow the Preferred Reporting Items for Systematic reviews and Meta-Analysis for study selection and reporting. We will use The Cochrane Handbook for Systematic Reviews of Interventions and Meta-Analysis as guidance to select eligible studies. All data will be extracted using a standardised data extraction form. ETHICS AND DISSEMINATION: There was no patient involved in this study, therefore no ethical consideration is needed. The findings of this study will be disseminated in a peer-reviewed journal and any relevant conference presentation. PROSPERO REGISTRATION NUMBER: CRD42019123286.