The influence of potassium nanoparticles as a foliar fertilizer on onion growth, production, chemical content, and DNA fingerprint.

Potassium is an important macro-fertilizer for plant growth but can be lost from the soil after application via irrigation. Slow-release nano-fertilizers can achieve sustainable crop cultivation and production, so this study evaluated the influence of potassium nanoparticles (K-NPs) with various concentrations (0, 50, 100, and 200 mg/l) on onion development, production, pigments, chemical content, and DNA fingerprint during two sequential agriculture seasons in 2021 and 2022 at a private farm in Zagazig, Sharkia Governorate, Egypt. Spraying onion plants with K-NPs (200 mg/l) significantly improved the vegetative characteristics of onion plant growth and production, as well as increasing the plant pigments and the content of carbohydrate, oil, total indole, and phosphorus in onion bulbs. Similarly, 50 mg/l of K-NPs considerably increased the content of nitrogen, potassium, protein, antioxidant activity, and phenols in the onion bulbs. The content of total flavonoids and anthocyanin was increased with 100 mg/l of K-NPs. In conclusion, the foliar application of K-NPs improves the onion plant yield and quality and can achieve agricultural sustainability.

Understanding the factors that influence CT utilization for mild traumatic brain injury in a low resource setting - a qualitative study using the Theoretical Domains Framework.

Introduction: In low resource settings (LRS), utilization of Computed Tomography scan (CTS) for mild traumatic brain injuries (mTBIs) presents unique challenges and considerations given the limited infrastructure, financial resources, and trained personnel. The Theoretical Domains Framework (TDF) offers a comprehensive theoretical lens to explore factors influencing the decision-making to order CTS for mTBI by imaging referrers (IRs). Objectives: The primary objective was to explore IRs' beliefs about factors influencing CT utilization in mTBIs using TDF in Uganda.Differences in the factors influencing CTS ordering behavior across specialties, levels of experience, and hospital category were also explored. Materials and Methods: In-depth semi-structured interviews guided by TDF were conducted among purposively selected IRs from 6 tertiary public and private hospitals with functional CTS services. A thematic analysis was performed with codes and emerging themes developed based on the TDF. Results: Eleven IRs including medical officers, non-neurosurgeon specialists and neurosurgeons aged on average 42 years (SD+/-12.3 years) participated.Identified factors within skills domain involved IRs' clinical assessment and decision-making abilities, while beliefs about capabilities and consequences encompassed their confidence in diagnostic abilities and perceptions of CTS risks and benefits. The environmental context and resources domain addressed the availability of CT scanners and financial constraints. The knowledge domain elicited IRs' understanding of clinical guidelines and evidence-based practices while social influences considered peer influence and institutional culture. For memory, attention & decision processes domain, IRs adherence to guidelines and intentions to order CT scans were cited. Conclusion: Using TDF, IRs identified several factors believed to influence decision making to order CTS in mTBI in a LRS. The findings can inform stakeholders to develop targeted strategies and evidence-based interventions to optimize CT utilization in mTBI such as; educational programs, workflow modifications, decision support tools, and infrastructure improvements, among others.

Assessing and improving radiation safety in cardiac catheterization: a study from Cairo University Hospital.

BACKGROUND: Catheter laboratories are high-radiation exposure environments, especially during X-ray procedures like percutaneous transluminal coronary angioplasty and electrophysiological studies. Radiation exposure poses risks of stochastic (e.g., cancer) and deterministic (e.g., skin changes) effects. This study assessed radiation safety and health practices in a cardiac catheterization unit to optimize radiation safety. A cross-sectional study in Cairo University Hospital (March-September 2019) evaluated 700 patients and healthcare workers. Real-time radiation measurements, educational lectures, and radiation protection measures were implemented in three phases. Data on radiation exposure, procedures, and compliance were collected and analyzed. RESULTS: The total procedure time and fluoroscopy time per cardiologist did not significantly differ between phases, but there was a statistically significant reduction in the mean total cumulative radiation doses between Phase I and Phase III for cardiologists (P = 0.013). Among nurses and technicians, there was no significant difference in radiation doses between the two phases. Significant correlations were found between operators' radiation doses, procedure time, and fluoroscopy time. Patients' radiation doses decreased significantly from Phase I to Phase III, with correlations between dose, procedure time, and gender. Compliance with radiation protection measures was suboptimal. CONCLUSIONS: Compliance with radiation safety standards in the cardiac catheterization unit at the Cairo University Hospital needs improvement. The study highlights the importance of adhering to radiation safety principles and optimizing protective measures to reduce radiation exposure for both patients and healthcare personnel. Despite low compliance, significant reductions in radiation doses were achieved with increased awareness and adherence to specific protection measures. Future efforts should focus on enhancing radiation safety protocols and organ-specific radiation impact assessments.

Effect of foliar application of phosphorus nanoparticles on the performance and sustainable agriculture of sweet corn.

Traditional phosphorus fertilizers are necessary for plant growth but about 80-90% are lost into the surrounding environment via irrigation, therefore nano-fertilizers have been developed as slow-release fertilizers to achieve sustainable agriculture. This trial investigated the impact of the foliar application of hydroxyapatite nanoparticles (HA-NPs) as a source of nano-phosphorus (P-NPs) on two cultivars of sweet corn (yellow and white) throughout two seasons. The morphology and structure of the prepared HA-NPs were characterized via transmission electron microscopy (TEM) and X-ray diffractometry (XRD). In addition, agro-morphological criteria, chemical contents (i.e., photosynthetic pigments, phenols, indoles, minerals, etc.), and genomic template stability percentage (GTS%) were evaluated in the produced sweet corn. The application of 50 mg/l HA-NPs improved the growth characteristics, yield per hectare, leaf pigments, and chemical content of yellow sweet corn, whereas the application of 100 mg/l of HA-NPs to white sweet corn enhanced the vegetative characteristics, production, photosynthetic pigments, phenols, and indoles. The difference in results may be due to the presence of a +ve unique band with SCoT-4 and SCot-2 primers at 1250 and 470 bp in yellow and white corn treated with 50 and 100 mg/l, respectively. The minimum GTS% was recorded at a concentration of 75 mg/l for both white and yellow corn. The HA-NPs can be applied as a foliar source of P-NPs to achieve agricultural sustainability.

A paradigm shift in point-of-care imaging in low-income and middle-income countries.

The concept of primary healthcare is now regarded as crucial for enhancing access to healthcare services in low-income and middle-income countries (LMICs). Technological advancements that have made many medical imaging devices smaller, lighter, portable and more affordable, and infrastructure advancements in power supply, Internet connectivity, and artificial intelligence, are all increasing the feasibility of POCI (point-of care imaging) in LMICs. Although providing imaging services at the same time as the clinic visit represents a paradigm shift in the way imaging care is typically provided in high-income countries where patients are typically directed to dedicated imaging centres, a POCI model is often the only way to provide timely access to imaging care for many patients in LIMCs. To address the growing burden of non-communicable diseases such as cancer and heart disease, bringing advanced imaging tools to the POCI will be necessary. Strategies tailored to the countries' specific needs, including training, safety and quality, will be of the utmost importance.

Toxoplasma gondii and Neospora caninum Antibodies in Dogs and Cats from Egypt and Risk Factor Analysis.

BACKGROUND: Toxoplasma gondii and Neospora caninum are major protozoan parasites of worldwide distribution and significance in veterinary medicine and, for T. gondii, in public health. Cats and dogs, as final hosts for T. gondii and N. caninum, respectively, have a key function in environmental contamination with oocysts and, thus, in parasite transmission. Very little is known about the prevalence of T. gondii infections in dogs and cats in Egypt, and even less about the prevalence of N. caninum in the same hosts. METHODS: In the current study, 223 serum samples of both dogs (n = 172) and cats (n = 51) were investigated for specific antibodies to T. gondii and N. caninum using commercially available ELISAs. A risk factor analysis was conducted to identify factors associated with seropositivity. RESULTS & DISCUSSION: Exposure to T. gondii was reported in 23.3% of the dogs and in 9.8% of the cats, respectively. In addition, N. caninum-specific antibodies were recorded in 5.8% of dogs and in 3.4% of cats. A mixed infection was found in two dogs (1.2%) and in one cat (2%). Antibodies to T. gondii in dogs were significantly more frequent in dogs aged 3 years or more and in male German Shepherds. As this breed is often used as watchdogs and was the most sampled breed in Alexandria governorate, the purpose "watchdog" (compared to "stray" or "companion"), the male sex, and the governorate "Alexandria" also had a significantly higher seroprevalence for T. gondii. No factors associated with antibodies to N. caninum could be identified in dogs, and no significant factors were determined in cats for either T. gondii or N. caninum infection. Our study substantially adds to the knowledge of T. gondii infection in dogs and cats and presents data on N. caninum infection in cats for the first and in dogs in Egypt for the second time.

The impact of nanofertilizer on agro-morphological criteria, yield, and genomic stability of common bean (Phaseolus vulgaris L.).

The use of agricultural fertilizers is one of the methods to beat the desired enormous increase in universal food production. The application of nanotechnology in agriculture is regarded as one of the promising approaches to elevate crop production. Whereas mineral nutrients play a crucial role in the growth and yield of the common bean. The experiments were conducted to investigate the application effect of micronutrients as nanoparticles (MN-NPs) on the common ben plants. The trial was performed in the field in El-Menofya, Egypt, through two seasons (2019 & 2020) in a randomized complete block design with three replicates and four combinations of MN-NPs (ZnO, MnO2 and MoO3) with concentrations 0, 10, 20, 30, 40 mg/L as a foliar application. The data exhibited that the foliar application of MN-NPs significantly upgraded the vegetative growth characters, flower number/plant, photosynthetic pigments, and yield. The concentration of 40 mg/L of MN-NPs leads to improving the vegetative growth, flowering number, and yield characteristics of the common bean. While the biochemical components varied in their response to MN-NPs combinations. The recommended MN-NPs concentration to ameliorate the common bean growth and yield was 40 mg/L.

Delayed complex fronto-zygomatico-orbital reconstruction using patient specific 3D printed implants; A report of three complex cases - A short communication.

PURPOSE: To demonstrate use of patient specific implants (PSIs) in the reconstruction of significant facial skeletal defects. Polyamide 12 implants were used to achieve good symmetric results with great projection and contours and minimal morbidity, all of which would not be predictably achievable with other reconstructive options. METHODS: Using a retrospective study design, three patients who had significant facial skeletal defects affecting the zygomaticomaxillary complex, frontal bone and also having an orbital component were used as subjects. The cases reported in this article were managed during the period from June 2015 to May 2016 with a minimum of 5 years follow up for all three cases. Outcomes were evaluated radiographically by overlapping postoperative x-rays with the virtual plan and also clinically using a virtual analogue scale (VAS). RESULTS: For the three patients, VAS assessment for patient satisfaction yielded promising results with the first case reporting an 8, with 10 being most satisfied. For the second patient, the VAS was 7.5 and for the third patient it was 8.5. Radiographically, the difference in transverse projection on all four points did not exceed 2.48 mm. When assessing antero-posterior projection accuracy, there was an average deviation of 0.68 mm at the infraorbital rim and 0.86 mm at the zygomaticofrontal point. CONCLUSION: This article aims to point out the significant advantages of the use of polyamide 12 PSIs for the major facial skeletal reconstructions regarding symmetry, anatomical contours, minimal morbidity and decreased costs. A larger number of patients is needed in future studies.

The effect of exposure to MoO3-NP and common bean fertilized by MoO3-NPs on biochemical, hematological, and histopathological parameters in rats.

Nanotechnologies has been used to introduce several beneficial tools in the agricultural field. Herein, the effect of molybdenum oxide nanoparticles (MoO3-NPs) was investigated by evaluating the hematological, biochemical, and histopathological parameters in rats orally exposed to MoO3-NPs or fed common beans (CB) fertilized by MoO3-NPs. In the first study, 18 rats were randomly divided into 3 groups: G1 (control group) was given water orally, while G2 and G3 were administered 10 and 40 ppm MoO3-NPs by oral gavage tube, respectively. There was a significant increase in the levels of alanine aminotransferase (ALT), albumin, and total protein; however, there was a a significant decrease in body weight change (BWC), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), creatinine, creatine kinase-MB (CK-MB), thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and testosterone levels in G3 compared to G1. In the second study, 24 rats were divided into 4 groups: the control (C) group was fed a balanced diet, and three groups were fed on a balanced diet plus 10% CB that was fertilized with 0, 10, and 40 ppm MoO3-NPs, resulting in nCB, CB10, and CB40 groups, respectively. This revealed a significant increase in BWC and total food intake (TFI) but a significant decrease in relative kidney weight in all the CB groups compared to the control group. In CB10 and CB40 groups ALT, LDH, TSH, FT3, and testosterone levels were significantly lower than the respective levels in the control group. We concluded that high doses of MoO3-NPs caused more side effects than low doses in both experiments.

2021 NATIONAL DIAGNOSTIC REFERENCE LEVELS FOR PAEDIATRIC COMPUTED TOMOGRAPHY IN EGYPT.

OBJECTIVE: To establish national diagnostic reference levels (NDRLs) for most common paediatric computed tomography (CT) examinations in Egypt. METHODS: This was a prospective study that included all dedicated paediatric imaging centers in Egypt. Data from 1680 individual paediatric patients undergoing CT scanning of the head, chest and abdomen-pelvis were collected. Computed tomography dose indices were recorded, data were analysed and compared with the internationally published paediatric DRLs in14 countries. RESULTS: The Egyptian NDRLs of the CTDIvol (mGy) for head, chest and abdomen-pelvis scans among four paediatric age groups were found to be (23, 27, 28, 32, 4, 5, 6, 8, 5, 6, 7, 9) mGy, respectively; and the corresponding NDRLs of the DLP (mGycm) for head, chest and abdomen-pelvis scans were found to be (345, 428, 499, 637, 67, 85, 145, 215, 97, 135, 240, 320) mGycm, respectively. There were variations in the radiation doses between CT centers and identical scanners indicating the need for dose optimization. The NDRLs of the CTDIvol (mGy) and the DLP (mGycm) values were similar to or lower than international DRLs. CONCLUSION: This study summarizes the results of the first Egyptian Computed Tomography survey that provides national diagnostic reference levels for paediatric patients in Egypt. Despite the reasonable NDRLs values, the study depicted certain pros and cons concerning CT practice, and identified some problems that hinder the process of optimization as well as justification in children.

An Africa point of view on quality and safety in imaging.

Africa has seen an upsurge in diagnostic imaging utilization, with benefits of efficient and accurate diagnosis, but these could easily be offset by undesirable effects attributed to unjustified, unoptimized imaging and poor quality examinations. This paper aims to present Africa's position regarding quality and safety in imaging, give reasons for the rising interest in quality and safety, define quality and safety from an African context, list drivers for quality and safety in Africa, discuss the impact of COVID-19 on quality and safety, and review Africa's progress using the Bonn Call for Action framework while proposing a way forward for imaging quality and safety in Africa. In spite of a healthcare setting characterized by meagre financial, human and technology resources, a rapidly widening disease-burden spectrum, growing proportion of non-communicable diseases and resurgence of tropical and global infections, Africa has over the last ten years made significant strides in quality and safety for imaging. These include raising radiation-safety awareness, interest and application of evidence-based radiation safety recommendations and guidance tools, establishing facility and national diagnostic reference levels (DRLs) and strengthening end-user education and training. Major challenges are: limited human resource, low prioritization of imaging in relation to other health services, low level of integration of imaging into the entire health service delivery, insufficient awareness for radiation safety awareness, a radiation safety culture which is emerging, insufficient facilities and opportunities for education and training. Solutions to these challenges should target the entire hierarchy of health service delivery from prioritization, policy, planning, processes to procedures.

Reconstruction of Cranial Bone Defects Using Polyamide 12 Patient-Specific Implant: Long Term Follow Up.

ABSTRACT: The main objective of this study was to evaluate the use of patient-specific polyamide 12 implants in cranial bone defect reconstruction.Ten patients who underwent prior decompression craniectomy were selected for the current study. Skull scanning by computerized tomography was performed and used to make virtual planning of the implants to be transformed into physical implant using selective laser sintering. Cranioplasty was performed through coronal surgical approach where cranial implants were fixated using 2.0-mm mini-screws, and plates. Patients follow-up was from 12 to 36 months. Glasgow Outcome Score recorded 1 (good recovery) for all patients. Patient and surgeon satisfaction for the esthetic outcome were measured using visual analog scale as mean of 10 ± 0 and 9 ± 1, respectively. Cranial symmetry index was calculated as mean score of 98% ± 1%, indicating highly accurate symmetry, and preoperative virtual planning and postoperative outcome were compared for accuracy analysis with a mean difference of 0.3197 ± 0.1649, which indicates high accuracy.Polyamide12 cranial implants seem to offer a promising option to cranial bone reconstruction with patient-specific implants. This study ensures proper cosmetic and clinical outcome.

Systematic review and meta-analysis of cohort studies of long term outdoor nitrogen dioxide exposure and mortality.

OBJECTIVE: To determine whether long term exposure to outdoor nitrogen dioxide (NO2) is associated with all-cause or cause-specific mortality. METHODS: MEDLINE, Embase, CENTRAL, Global Health and Toxline databases were searched using terms developed by a librarian. Screening, data extraction and risk of bias assessment were completed independently by two reviewers. Conflicts were resolved through consensus and/or involvement of a third reviewer. Pooling of results across studies was conducted using random effects models, heterogeneity among included studies was assessed using Cochran's Q and I2 measures, and sources of heterogeneity were evaluated using meta-regression. Sensitivity of pooled estimates to individual studies was examined and publication bias was evaluated using Funnel plots, Begg's and Egger's tests, and trim and fill. RESULTS: Seventy-nine studies based on 47 cohorts, plus one set of pooled analyses of multiple European cohorts, met inclusion criteria. There was a consistently high degree of heterogeneity. After excluding studies with probably high or high risk of bias in the confounding domain (n = 12), pooled hazard ratios (HR) indicated that long term exposure to NO2 was significantly associated with mortality from all/ natural causes (pooled HR 1.047, 95% confidence interval (CI), 1.023-1.072 per 10 ppb), cardiovascular disease (pooled HR 1.058, 95%CI 1.026-1.091), lung cancer (pooled HR 1.083, 95%CI 1.041-1.126), respiratory disease (pooled HR 1.062, 95%CI1.035-1.089), and ischemic heart disease (pooled HR 1.111, 95%CI 1.079-1.144). Pooled estimates based on multi-pollutant models were consistently smaller than those from single pollutant models and mostly non-significant. CONCLUSIONS: For all causes of death other than cerebrovascular disease, the overall quality of the evidence is moderate, and the strength of evidence is limited, while for cerebrovascular disease, overall quality is low and strength of evidence is inadequate. Important uncertainties remain, including potential confounding by co-pollutants or other concomitant exposures, and limited supporting mechanistic evidence. (PROSPERO registration number CRD42018084497).

Barriers and facilitators to implementing clinical imaging guidelines by healthcare professionals using theoretical domains framework: a mixed-methods systematic review protocol.

Objectives: To identify, categorize, and develop an aggregated synthesis of evidence using the theoretical domains framework (TDF) on barriers and facilitators that influence implementation of clinical imaging guidelines (CIGs) by healthcare professionals (HCPs) in diagnostic imaging. Methods: The protocol will be guided by the Joanna Briggs Institute Reviewers' Manual 2014. Methodology for JBI Mixed Methods Systematic Reviews and will adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA-P). Information source will include databases (MEDLINE, EMBASE and The Cochrane Library), internet search (https://www.google.com/scholar), experts' opinion, professional societies/organizations websites and government bodies strategies/recommendations, and reference lists of included studies. Articles of any study design published in English from 1990 to date, having investigated factors operating as barriers and/or facilitators to the implementation CIGs by HCPs will be eligible. Selecting, appraising, and extracting data from the included studies will be independently performed by at least two reviewers using validated tools and Rayyan - Systematic Review web application. Disagreements will be resolved by consensus and a third reviewer as a tie breaker. The aggregated studies will be synthesized using thematic analysis guided by TDF. Results: Identified barriers will be defined a priori and mapped into 7 TDF domains including knowledge, awareness, effectiveness, time, litigationand financial incentives. Conclusion: The results will provide an insight into a theory-based approach to predict behavior-related determinants for implementing CIGs and develop strategies/interventions to target the elicited behaviors. Recommendations will be made if the level of evidence is sufficient. Advances in knowledge: Resource-constrained settings that are in the process of adopting CIGs may opt for this strategy to predict in advance likely impediments to achieving the goal of CIG implementation and develop tailored interventions during the planning phase.Systematic review Registration: PROSPERO ID = CRD42020136372 (https://www.crd.york.ac.uk/PROSPERO).

Applications of nanotechnology on vegetable crops.

Agriculture is the backbone of most developing countries, and most of their people depend on it for their livelihood. The world population is increased by approximately 83 million people each year, so there is a need to increase agricultural productivity. At present, productivity growth can be achieved either by expanding the area cultivated or increasing crop yields through improving the efficiency of fertilizers used. Therefore, there has been a trend to use modern technologies, such as nanotechnology (NT), to increase the productivity of plants. Where, it is involved in the food production process, from planting to packaging. NT improves plants' ability to absorb nutrients, and the agronomic properties of soil, which improves plant growth and productivity. Economically, NT increased the efficiency of nano-fertilizers, and so contributed to increasing productivity and the production of crops. However, the study of the effect of nanotechnology on the environment of soils and plants did not receive the required study. In this review, a comprehensive survey is exhibited on NT as an effective method in dealing with the problem of fertilizer loss during irrigation. This review discusses the technologies and applications of the latest research findings in this field. Furthermore, this review deals with the forms and types of nanoparticles and the methods of their transmission in plants, as well as their effect on plants (physiological and DNA) as well as on those who eat those plants.

A rapid and simple single-step method for the purification of Toxoplasma gondii tachyzoites and bradyzoites.

This study describes a simple method for the large-scale isolation of pure Toxoplasma gondii tachyzoites and bradyzoites. T. gondii tachyzoites were obtained from infected human foreskin fibroblasts (HFFs) and peritoneal exudates of mice, while tissue cysts containing bradyzoites were collected from chronically infected mice. Harvested cells and brain tissues were incubated in Hanks balanced salt solution (HBSS), containing 0.25% trypsin and 0.5% taurodeoxycholic acid (TDC) for 5 min. Subsequent washes in phosphate buffered saline (PBS) were conducted, and the cell viability of the preparations was good, as determined by flow cytometry and ability to reinfect HFF cells and propagate in mice. The purification procedure allowed for a rapid preparation of pure T. gondii tachyzoites and bradyzoites in sufficient quantity that can be used for downstream procedures. The advantage of the new method is that it is convenient and inexpensive.

The role and contribution of treatment and imaging modalities in global cervical cancer management: survival estimates from a simulation-based analysis.

BACKGROUND: Cervical cancer is the fourth most common cancer among women worldwide, causing more than 300 000 deaths globally each year. In addition to screening and prevention, effective cancer treatment is needed to reduce cervical cancer mortality. We discuss the role of imaging in cervical cancer management and estimate the potential survival effect of scaling up imaging in several different contexts. METHODS: Using a previously developed microsimulation model of global cancer survival, we estimated stage-specific cervical cancer 5-year net survival in 200 countries and territories. We evaluated the potential survival effect of scaling up treatment (chemotherapy, surgery, radiotherapy, and targeted therapy), and imaging modalities (ultrasound, x-ray, CT, MRI, PET, and single photon emission CT [SPECT]) to the mean level of high-income countries, both individually and in combination. FINDINGS: We estimate global cervical cancer 5-year net survival as 42·1% (95% uncertainty interval [UI] 33·8-48·5). Among individual imaging modalities, expanding MRI would yield the largest 5-year survival gains globally (data are absolute percentage point increase in survival 0·6, 95% UI 0·1-2·1), scaling up ultrasound would yield the largest gains in low-income countries (0·5, 0·0-3·7), expanding CT and x-ray would have the greatest effect in Latin America (0·8, 0·0-3·4) and Oceania (0·4, 0·0-3·2), and expanding PET would yield the largest gains in high-income countries (0·2, 0·0-0·8). Scaling up SPECT did not show major changes in any region. Among individual treatment modalities, scaling up radiotherapy would yield the largest absolute percentage point gains in low-income countries (5·2, 0·3-13·5), and expanding surgery would have the largest effect in lower-middle-income countries (7·4, 0·3-21·1) and upper-middle-income countries (0·8, 0·0-2·9). Estimated survival gains in high-income countries were very modest. However, the gains from expanding any single treatment or imaging modality individually were small across all income levels and geographical settings. Scaling up all treatment modalities could improve global 5-year net survival to 52·4% (95% UI 44·6-62·0). In addition to expanding treatment, improving quality of care could raise survival to 57·5% (51·2-63·5), and the cumulative effect of scaling up all imaging modalities together with expanded treatment and quality of care could improve 5-year net survival for cervical cancer to 62·5% (57·7-67·8). INTERPRETATION: Comprehensive scale-up of treatment, imaging, and quality of care could substantially improve global cervical cancer 5-year net survival, with quality of care and imaging improvements each contributing about 25% of the total potential gains. These findings suggest that a narrow focus on the availability of treatment modalities could forgo substantial survival gains. Investments in imaging equipment, personnel, and quality of care efforts will also be needed to successfully scale up cervical cancer treatment worldwide. FUNDING: Harvard T H Chan School of Public Health and National Cancer Institute.

Computed tomography radiation doses for common computed tomography examinations: a nationwide dose survey in United Arab Emirates.

OBJECTIVES: Computed tomography (CT) scanning is an essential part of diagnostic and treatment plans, providing swift and accurate diagnostic images. The aim of this study is to develop diagnostic reference levels (DRLs) for the adult common CT examination in the United Arab Emirates (UAE). METHODS: This study presents results of the survey of CT dose indices. The data were collected from 91% of the scanners registered at the Ministry of Health and Prevention (MOHAP) for five common examinations: head, chest, and abdomen-pelvis with and without CM. RESULTS: CT dose index, dose-length product, and patient weight were analyzed; the reference dose was calculated on the 75th percentile, and an achievable dose was proposed from the median value. The results were compared with the UAE initial National Dose Report as well as the international reports. The proposed dose for CTDIvol (mGy) and DLP (mGy cm) is as follows: head without CM 40 and 695, head with CM 48 and 820, chest 10 and 275, abdomen-pelvis without CM 14 and 810, and abdomen-pelvis with CM 20 and 1025. CONCLUSIONS: The results show low dose variations between the MOHAP scanners. The data also revealed CTDIvol and DLP values comparable to those in the initial NDRL report and international standards. The establishment of diagnostic reference levels will require a continuous dose monitoring system.

Correction to: Systematic review and meta-analysis of case-crossover and time-series studies of short term outdoor nitrogen dioxide exposure and ischemic heart disease morbidity.

An amendment to this paper has been published and can be accessed via the original article.

Systematic review and meta-analysis of case-crossover and time-series studies of short term outdoor nitrogen dioxide exposure and ischemic heart disease morbidity.

BACKGROUND: Nitrogen dioxide (NO2) is a pervasive urban pollutant originating primarily from vehicle emissions. Ischemic heart disease (IHD) is associated with a considerable public health burden worldwide, but whether NO2 exposure is causally related to IHD morbidity remains in question. Our objective was to determine whether short term exposure to outdoor NO2 is causally associated with IHD-related morbidity based on a synthesis of findings from case-crossover and time-series studies. METHODS: MEDLINE, Embase, CENTRAL, Global Health and Toxline databases were searched using terms developed by a librarian. Screening, data extraction and risk of bias assessment were completed independently by two reviewers. Conflicts between reviewers were resolved through consensus and/or involvement of a third reviewer. Pooling of results across studies was conducted using random effects models, heterogeneity among included studies was assessed using Cochran's Q and I2 measures, and sources of heterogeneity were evaluated using meta-regression. Sensitivity of pooled estimates to individual studies was examined using Leave One Out analysis and publication bias was evaluated using Funnel plots, Begg's and Egger's tests, and trim and fill. RESULTS: Thirty-eight case-crossover studies and 48 time-series studies were included in our analysis. NO2 was significantly associated with IHD morbidity (pooled odds ratio from case-crossover studies: 1.074 95% CI 1.052-1.097; pooled relative risk from time-series studies: 1.022 95% CI 1.016-1.029 per 10 ppb). Pooled estimates for case-crossover studies from Europe and North America were significantly lower than for studies conducted elsewhere. The high degree of heterogeneity among studies was only partially accounted for in meta-regression. There was evidence of publication bias, particularly for case-crossover studies. For both case-crossover and time-series studies, pooled estimates based on multi-pollutant models were smaller than those from single pollutant models, and those based on older populations were larger than those based on younger populations, but these differences were not statistically significant. CONCLUSIONS: We concluded that there is a likely causal relationship between short term NO2 exposure and IHD-related morbidity, but important uncertainties remain, particularly related to the contribution of co-pollutants or other concomitant exposures, and the lack of supporting evidence from toxicological and controlled human studies.