Responses of microbial communities in rhizocompartments of king grass to phytoremediation of cadmium-contaminated soil.

King grass has been recognized as a potential phytoremediation plant species due to its high biomass and resistance to heavy metals (HMs). However, the possible impacts of cadmium (Cd) contamination on rhizocompartments' microbial activities in association with king grass have not been extensively explored. The utilization of 16S rRNA gene and ITS sequencing was carried out to examine alterations in the bacterial and fungal communities in the rhizosphere and rhizoplane of king grass in response to low and high Cd stress. Results demonstrated that both bacterial and fungal communities' diversity and richness were negatively impacted by Cd stress, regardless of its concentration. However, evenness did not exhibit any significant response to either of the concentrations. Additionally, nonmetric multidimensional scaling (NMDS) ordination demonstrated a significant difference (p < 0.001) in microbial communities under different treatments. The abundance of bacterial taxa such as Steroibacter, Nitrospira, Pseudoxanthomonas, Cellvirio, Phenylobacterium, Mycobacterium, Pirellula and Aquicella was adversely affected under Cd stress while Flavobacterium, Gemmata, Thiobacillus and Gemmatimonas showed no prominent response, indicating their resistance to Cd stress. Like that, certain fungal taxa for instance, Cladosporium, Cercophora, Acremonium, Mortierella, Aspergillus, Penicillium, Glomus and Sebacina were also highly reduced by low and high Cd stress. In contrast, Fusarium, Thanatephorus, Botrytis and Curvularia did not show any response to Cd stress. The identified taxa may have a crucial role in the growth of king grass under heavy metal contamination, making them promising candidates for developing bioinoculants to encourage plant performance and phytoremediation capability in HM-contaminated soils.

Measurement of age-dependent radiation ingestion doses due to gross alpha and gross beta exposure from medicinal plants.

This article presents the results of a study conducted to measure the gross alpha, gross beta activities in medicinal plant samples collected from different districts of Azad Kashmir, Pakistan. The ASC-950-DP gasless high-speed counter was used for the measurement of gross α/ß activities. Measured activities have been used to assess age-dependent annual effective doses for infants, one-, five-, ten-, and fifteen-year-old and adult people. For a medicinal plant consumption rate (MPCR) of 1.8 kg a-1, the average gross alpha and beta annual committed effective dose (ACED) delivered to one-, five-, ten-, fifteen-year-olds and adults fall below the WHO recommended level (290 µSv a-1) and that reported in the UNSCEAR 2000 (0.3 mSv a-1) report. Results obtained for the current study show that the radiological hazard related to the consumption of natural radionuclides in medicinal plants is inconsequential with exception of the ACED delivered to infants at an MPCR of 1.8 g a-1 and higher values.

Moderating role of institutional quality in validation of pollution haven hypothesis in BRICS: a new evidence by using DCCE approach.

The technological innovation and strict environmental protocols in the highly developed regions have become the primary sources for foreign direct investment to move in the pollution haven economies. In this regard, this study attempted to identify the role of foreign direct investment (FDI) in the developing economies of the Brazil, Russia, India, China, and South Africa (BRICS) region. For this reason, a dataset was obtained between 1995 and 2019. Chudik and Pesaran's (2015) latest dynamic common correlated effects (DCCE) technique is used because of its new features when integrating the problems of heterogeneity and structural breaks into panel data that are general and do not encompass much recent research in this context. According to the empirical outcomes, foreign direct investment is a source of pollution haven in this region. However, the moderating effect of institutional quality on foreign direct investment has been found negative for ecological footprint. It also found the threshold point where the foreign direct investment effect becomes negative on ecological footprint. Based on these empirical results, this research suggests that foreign direct investment strategy should be maintained in the presence of good institutional efficiency as it enhances the environment and promotes economic development.

Economic growth, fiscal imbalance, and environmental sustainability: What is desirable and undesirable for developing economies?

Developing economies are suffering to fulfill the sustainable environment's commitments in fiscal imbalance. This study attempted to highlight the core issue of fiscal imbalance in developing economies and its impact on a sustainable environment. For this purpose, the study utilized generalized least squares (GLS) and quantile autoregressive distributive lag (QARDL) on a 19-year dataset (2000-2018) of the South Asian region. The results of GLS indicate that fiscal imbalance contributing positively to South Asia's environmental degradation process. Here, energy consumption (due to dirty sources of energy) and energy intensity (due to inefficient energy conversion technology) are also sources of environmental degradation in this region. The results of QARDL confirm that economic and political fluctuations can be the long-run source of fiscal imbalance in this region, which ultimately slows down the process of the environmental Kuznets curve (EKC) theory and contributes positively to environmental degradation. Based on the empirical analysis, this study provides a comprehensive set of policy guidance for developing and developed economies for the smooth transition of sustainable environmental conditions in South Asia.

Nanomaterials as drug delivery systems with antibacterial properties: current trends and future priorities.

Introduction:Despite extensive advances in the production and synthesis of antibiotics, infectious diseases are one of the main problems of the 21st century due to multidrug-resistant (MDR) distributing in organisms. Therefore, researchers in nanotechnology have focused on new strategies to formulate and synthesis the different types of nanoparticles (NPs) with antimicrobial properties.Areas covered:The present review focuses on nanoparticles which are divided into two groups, organic (micelles, liposomes, polymer-based and lipid-based NPs) and inorganic (metals and metal oxides). NPs can penetrate the cell wall then destroy permeability of cell membrane, the structure and function of cell macromolecules by producing of reactive oxygen species (ROS) and eventually kill the bacteria. Moreover, their characteristics and mechanism in various bacteria especially MDR bacteria and finally their biocompatibility and the factors affecting their activity have been discussed.Expert opinion:Nanotechnology has led to higher drug absorption, targeted drug delivery and fewer side effects. NPs can overcome MDR through affecting several targets in the bacteria cell and synergistically increase the effectiveness of current antibiotics. Moreover, organic NPs with regard to their biodegradability and biocompatibility characteristics can be suitable agents for medical applications. However, they are less stable in environment in comparison to inorganic NPs.

Resveratrol and Celastrol Loaded Collagen Dental Implants Regulate Periodontal Ligament Fibroblast Growth and Osteoclastogenesis of Bone Marrow Macrophages.

Collagen is widely used for dental therapy in several ways such as films, 3D matrix, and composites, besides traditional Chinese medicine (TCM), has been used in tissue regeneration and wound healing application for centuries. Hence, the present study was targeted for the first time to fabricate collagen film with TCM such as resveratrol and celastrol in order to investigate the human periodontal ligament fibroblasts (HPLF) growth and bone marrow macrophages (BMM) derived osteoclastogenesis. Further, the physicochemical, mechanical and biological activities of collagen-TCM films crosslinked by glycerol and EDC-NHS (1-ethyl-3-(3-dimethylaminopropyl)carbodiimide-N-hydroxysulfosuccinimide) were investigated. Collagen film characterization was significantly regulated by the nature of plasticizers like hydrophobic and degree of polarity. Interestingly, the collagen film's denaturation temperature was increased by EDC-NHS than glycerol. FT-IR data confirmed the functional group changes due to chemical interaction of collagen with TCM. Morphological changes of HPLF cells cultured in control and collagen films were observed by SEM. Importantly, the addition of resveratrol upregulated the proliferation of HPLF cells, while osteoclastogenesis of BMM cells treated with mCSF-RANKL was significantly downregulated by celastrol. Accordingly, the collagen-TCM film could be an interesting material for dental regeneration, and especially it is a therapeutic target to restrain the elevated bone resorption during osteoporosis.

Pollen morphological variation of Berberis L. from Pakistan and its systematic importance.

Due to overlapping and diverse morphological characters, Berberis is among the most taxonomically complex genera. Palynology is one of the taxonomic tools for delimitation and identification of complex species. In this study, pollens of 10 Berberis species were analyzed through light and scanning electron microscopy. Qualitative as well as quantitative features (pollen shape, size, presence or absence of colpi, colpi length and width, exine thickness, ornamentation, pollen class, aperture, and polar-equatorial ratio) were measured. Five species were observed to have colpate (pantocolpate) with elongated ends, radially symmetrical, isopolar, monads, and psilate-regulate pollens. In polar view, six pollen were spheroidal, two were ovoid, one spherical, and one oblate. Similarly, variation in pollen length was prominent and the largest pollen on polar view was recorded for B. psodoumbellata 60-65 µm (62.4 ± 0.9), while the smallest one was observed for B. lycium 29-35 µm (32.2 ± 1). The observed variation in both quantitative and qualitative features were important in taxonomic identification. This shows that palynological characters are helpful in identification of Berberis genus at the species level.

Hydration Marker Diagnostic Accuracy to Identify Mild Intracellular and Extracellular Dehydration.

Identifying mild dehydration (≤2% of body mass) is important to prevent the negative effects of more severe dehydration on human health and performance. It is unknown whether a single hydration marker can identify both mild intracellular dehydration (ID) and extracellular dehydration (ED) with adequate diagnostic accuracy (≥0.7 receiver-operating characteristic-area under the curve [ROC-AUC]). Thus, in 15 young healthy men, the authors determined the diagnostic accuracy of 15 hydration markers after three randomized 48-hr trials; euhydration (water 36 ml·kg-1·day-1), ID caused by exercise and 48 hr of fluid restriction (water 2 ml·kg-1·day-1), and ED caused by a 4-hr diuretic-induced diuresis begun at 44 hr (Furosemide 0.65 mg/kg). Body mass was maintained on euhydration, and dehydration was mild on ID and ED (1.9% [0.5%] and 2.0% [0.3%] of body mass, respectively). Urine color, urine specific gravity, plasma osmolality, saliva flow rate, saliva osmolality, heart rate variability, and dry mouth identified ID (ROC-AUC; range 0.70-0.99), and postural heart rate change identified ED (ROC-AUC 0.82). Thirst 0-9 scale (ROC-AUC 0.97 and 0.78 for ID and ED) and urine osmolality (ROC-AUC 0.99 and 0.81 for ID and ED) identified both dehydration types. However, only the thirst 0-9 scale had a common dehydration threshold (≥4; sensitivity and specificity of 100%; 87% and 71%, 87% for ID and ED). In conclusion, using a common dehydration threshold ≥4, the thirst 0-9 scale identified mild intracellular and ED with adequate diagnostic accuracy. In young healthy adults', thirst 0-9 scale is a valid and practical dehydration screening tool.

Patient perceptions and preferences of physicians' attire in Saudi primary healthcare setting.

Background: Since the time of Hippocrates, dress of the care-giver has been known to influence patient's perception about the physician. Objectives: To explore patient's preference about physician's dress in Saudi primary healthcare, and how it influences their perception, regarding professionalism, competence, and confidence in the physician. Methods: A cross sectional study conducted in primary care clinics in Riyadh, enrolling 443 patients, who filled a self-administered Arabic questionnaire, enquiring about physician clothes such as white coat, scrubs and 'thob (white-robe) shomagh (head cover)' for males, 'veil-skirt' for females, and shoes. Patients' preferences about physicians' dresses were explored and influence of favorable dress on professionalism and trustworthiness were explored, using Chi-sq, Mann Whitney, with p ≤ .05 as significant. Principle component analysis was used to search themes in attire commonly used. Results: Over 80% of patients visiting Saudi primary care, liked seeing their physician in white coat. Traditional dress 'thob and shomagh' was approved by 47% whereas 'veil and skirt' got acceptance of 62%. Dress of physician was significantly (p < .005) more important to patients, who were male (Chi-sq 14.95), working (Chi-sq 9.39), educated (Chi-sq 9.84), urbanites (Chi-sq 18.34) and married (Chi-sq 7.89). Patients who valued physician attire (70%) perceived it positively influencing doctor-patient relationship: Mann Whitney U score = 6879, p-value <0.001. Four dress-themes emerged: 'Professional modest', 'Expensive modern', 'Traditional formal' and 'Casual shoes'. Conclusion: Patients preferred white coats for their doctors. Half of participants accepted traditional dresses. Majority valued physician's attire as a positive influence.

Prevalence of subclinical hypothyroidism in adults visiting primary health-care setting in Riyadh.

Background and objectives: Subclinical hypothyroidism is an asymptomatic condition with normal thyroxin and raised thyroid stimulating hormone (TSH) level. The objective of the study was to determine the prevalence of subclinical hypothyroidism in primary health care (PHC) settings in Riyadh and explore the relationship of TSH level with age, gender, family history, body mass index, and co-morbid conditions. Subjects and methods: A cross-sectional study of adult visitors to nine satellites PHC clinics in military housing in Riyadh was carried out. TSH concentration and free T4 levels were measured. Data were collected by nurses and physicians during routine clinical practice in primary care. Descriptive analysis was performed on all variables in study, and relationships were explored using chi-square, t-test, analysis of variance, and linear regression. Results: A total of 340 out of 394 participants in the study gave blood samples. Subclinical hyperthyroidism was identified in 2.1% (p = .001) and subclinical hypothyroidism in 10.3% (p = .001) of the PHC visitors. TSH levels were found to be significantly higher (p = .047) in elderly population of ≥60 years and those with family history of thyroid disease. Non-significant upward trends were noted in TSH levels with hyperlipidemia and increasing blood pressure. No overt hyperthyroidism or hypothyroidism was found in our study sample. Conclusion: Subclinical hypothyroidism has a prevalence of 10% of adults visiting PHC's. TSH levels are higher in the elderly, which warrants screening of those aged 60 years and above.

Class attendance and cardiology examination performance: a study in problem-based medical curriculum.

BACKGROUND AND AIMS: Information on the effect of students' class attendance on examination performance in a problem-based learning medical curriculum is limited. This study investigates the impact of different educational activities on students' academic performance in a problem-based learning curriculum. METHODS: This is a retrospective cohort study conducted on the cardiology block at the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. All students who undertook the cardiology block during the academic year 2011-2012 were included. The students' attendance was measured using their overall attendance percentage. This percentage is a product of their attendance of many activities throughout the block. The students' performance was assessed by the final mark obtained, which is a product of many assessment elements. Statistical correlation between students' attendance and performance was established. RESULTS: A total of 127 students were included. The average lecture attendance rate for the medical students in this study was found to be 86%. A significant positive correlation was noted between the overall attendance and the accumulated students' block mark (r=0.52; P<0.001). Students' attendance to different education activities was correlated to their final mark. Lecture attendance was the most significant predictor (P<0.001), that is, 1.0% increase in lecture attendance has predicted a 0.27 increase in students' final block mark. CONCLUSION: Class attendance has a positive effect on students' academic performance with stronger effect for lecture attendance compared to attendance in other teaching modalities. This suggests that lecture attendance is critical for learning even when a problem-based learning medical curriculum is applied.

The demographic and clinical characteristics of leprosy in Saudi Arabia.

Leprosy is a chronic disease caused by Mycobacterium leprae. Although the occurrence of leprosy has declined in Saudi Arabia, it has not yet been eradicated. To our knowledge, this descriptive retrospective study is the first to assess the clinical presentation of leprosy at the time of diagnosis in Saudi Arabia. All study subjects were leprosy patients admitted to Ibn Sina hospital, the only referral hospital for leprosy in Saudi Arabia, between January 2000 and May 2012. A total of 164 subjects, the majority of whom (65%) were between 21 and 50 years of age, were included, and the male-to-female ratio was 2.8:1. Of these 164 patients, 63% were Saudis, and 77% of all admitted patients were from the western region. Lepromatous leprosy was observed most frequently (33%), and 31% of cases had a positive history of close contact with leprosy. At the time of diagnosis, 84% of all subjects presented with skin manifestation. The prevalence of neurological deficit at the time of diagnosis was 87%. Erythema nodosum leprosum (E.N.L.) developed in only 10% of all subjects. Further studies are needed to determine the clinical characteristics pertaining to each type of leprosy in the region, and training courses in caring for and diagnosing patients with leprosy should be organized for health workers.

Adult depression screening in Saudi primary care: prevalence, instrument and cost.

BACKGROUND: By the year 2020 depression would be the second major cause of disability adjusted life years lost, as reported by the World Health Organization. Depression is a mental illness which causes persistent low mood, a sense of despair, and has multiple risk factors. Its prevalence in primary care varies between 15.3-22%, with global prevalence up to 13% and between 17-46% in Saudi Arabia. Despite several studies that have shown benefit of early diagnosis and cost-savings of up to 80%, physicians in primary care setting continue to miss out on 30-50% of depressed patients in their practices. METHODS: A cross sectional study was conducted at three large primary care centers in Riyadh, Saudi Arabia aiming at estimating point prevalence of depression and screening cost among primary care adult patients, and comparing Patient Health Questionnaires PHQ-2 with PHQ-9. Adult individuals were screened using Arabic version of PHQ-2 and PHQ-9. PHQ-2 scores were correlated with PHQ-9 scores using linear regression. A limited cost-analysis and cost saving estimates of depression screening was done using the Human Capital approach. RESULTS: Patients included in the survey analysis were 477, of whom 66.2% were females, 77.4% were married, and nearly 20% were illiterate. Patients exhibiting depressive symptoms on the basis of PHQ9 were 49.9%, of which 31% were mild, 13.4% moderate, 4.4% moderate-severe and 1.0% severe cases. Depression scores were significantly associated with female gender (p-value 0.049), and higher educational level (p-value 0.002). Regression analysis showed that PHQ-2 & PHQ-9 were strongly correlated R = 0.79, and R2 = 0.62. The cost-analysis showed savings of up to 500 SAR ($133) per adult patient screened once a year. CONCLUSION: The point prevalence of screened depression is high in primary care visitors in Saudi Arabia. Gender and higher level of education were found to be significantly associated with screened depression. Majority of cases were mild to moderate, PHQ-2 was equivocal to PHQ 9 in utility and that screening for depression in primary care setting is cost saving.

Indoor radon concentrations and assessment of doses in four districts of the Punjab Province - Pakistan.

Seasonal indoor radon measurement studies have been carried out in four districts, namely, Jhelum, Chakwal, Rawalpindi and Attock of the Punjab Province. In this regard, CR-39 based detectors were installed in bedrooms, drawing rooms and kitchens of 40 randomly selected houses in each district. After exposing to radon in each season, CR-39 detectors were etched in 6M NaOH at 80 degrees C and counted under an optical microscope. Indoor radon activity concentrations in the houses surveyed ranged from 15 +/- 4 to 176 +/- 7 Bq m(-3) with an overall average value of 55 +/- 31 Bq m(-3). The observed annual average values are greater than the world average of 40 Bq m(-3). Maximum indoor radon concentration levels were observed in winter season whereas minimum levels were observed in summer season. None of the measured radon concentration value exceeded the action level of 200-400 Bq m(-3). The season/annual ratios for different type of dwellings varied from 0.87 +/- 0.93 to 1.14 +/- 1.10. The mean annual estimated effective dose received by the residents of the studied area was found to be 1.39 +/- 0.78 mSv. The annual estimated effective dose is less than the recommended action level (3-10 mSv).

Investigation of the Occurrence of Human Errors in Treatment of Cancer Patients with External Beam Radiotherapy.

The main objective of clinical radiotherapy procedures is to deliver accurate doses to cancer patients. However, human errors can occur during the treatment planning and dose delivery that may result in under- or overexposure to the patient. Therefore the aim of the present study was to detect and quantify different types of errors that may occur during radiation treatment at the Nuclear Medicine, Oncology and Radiotherapy Institute (NORI) in Islamabad, Pakistan. In this context, systematic studies were carried out over an 18-month period at NORI, for which 800 patients were selected. Eight different types of human errors were detected and corrected before or during the first five radiation therapy fractions. Errors detected during the dose calculation and patient setup steps were ∼22% and ∼14% of the total incidents, respectively. Wedge/shielding blocks placement and field size settings-related errors were ∼10% and 19%, whereas source-surface distance/source-axis distance settings-related errors were ∼8%. Errors observed during treatment time/monitor unit, gantry/collimator angle settings, and counting fraction were about 7%, 9%, and 11%, respectively. Of the 105 errors detected, 28 were major errors (deviation from the prescribed daily dose ≥5%) and 77 were minor errors. The occurrence of minor and major error rates were 9.6% and 3.5%, respectively.