In vitro Screening of Glutathione- S -Transferase Inhibition by Different Extracts of Verbascum sinuatum

Background and Aim: The concern toward using herbs as enzyme inhibitors such as glutathione-s-transferases (GSTs) may result in the improvement of proliferative diseases. Moreover, it may overcome the problem of multidrug resistance tumors. Based on that, this experiment was conducted to detect the impact of using aqueous, ethanol and methanol extracts from Verbascum sinuatum L. (Scrophulariaceae) that grow wild in Palestine as enzymatic inhibitors. Materials and Methods: The impacts of these three extracts at four studied concentrations (250, 500, 750 and 1000 µg/mL) on the activity of purified hepatic glutathione-s-transferases were estimated spectrophotometrically by using-chloro-2,4-dinitro-benzene (CDNB) as substrate. Results: The results of the present research indicated that all the three prepared extracts of V. sinuatum could inhibit the activity of GSTs at all examined concentrations. Moreover, according to the results, the alcoholic extracts from the studied plant species were more influential in the activity of GSTs than the aqueous ones. However, minor inhibitory variations were observed between methanol and ethanol extracts. It is notable that all the studied extracts manifested inhibitory effects in a dose-dependent manner. Conclusion: The results of this study emphasized the possibility of utilizing V. sinuatum extracts in pharmaceutical industry of new medications to fight drug resistant tumors in general and GST-induced tumors in particular

A cross-sectional study on the impact of the COVID-19 pandemic on psychological outcomes: Multiple indicators and multiple causes modeling

Although the psychological impact of coronavirus disease 2019 (COVID-19) has been evaluated in the literature, further research is needed, particularly on post-traumatic stress disorder (PTSD) and psychological outcomes, is needed. This study aims to investigate the effect of the COVID-19 pandemic on psychological outcomes (depression, anxiety, and insomnia). A cross-sectional study using an online survey was conducted using the following instruments: Impact of Event Scale-Revised (IES-R), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder (GAD-7), and Insomnia Severity Index (ISI). Confirmatory factor analysis (CFA), structural equation model (SEM), multiple indicators and multiple causes (MIMIC) modeling, and differential item functioning (DIF) were performed to analyze the collected data. According to the results, participants with PTSD (n = 360) showed a higher level of depression, anxiety, and insomnia than those without PTSD (n = 639). Among the participants, 36.5% experienced moderate to severe symptoms of depression, and 32.6% had mild depressive symptoms. Moreover, 23.7% of participants experienced moderate to severe anxiety symptoms, and 33.1% had mild anxiety symptoms. In addition, 51.5% of participants experienced symptoms of insomnia. In conclusion, the PTSD caused by COVID-19 is significantly associated with depression, anxiety, and insomnia at the level of latent constructs and observed variables.Scopu

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Antibacterial Activity of Selected Plant Extracts on Methicillin Resistant Staphylococcus aureus

Based on the importance of herbal plants in medicine, this study was conducted to evaluate the antibacterial efficacy of aqueous, ethanol and methanol extracts of Thymbra spicata, Nepeta curviflora, and Verbascum fruticulosum against two clinical isolates (I and II) of the gram positive methicillin resistant Staphylococcus aureus (MRSA). Agar well diffusion method was performed to examine the antibacterial activity of all studied plant extracts. Micro-broth dilution method was used to measure the minimum inhibitory concentration (MIC) then the minimum bacteriocidal concentration (MBC) for all active extracts. The examined isolates were susceptible to the prepared plant extracts. Ethanol and methanol extracts of T. spicata were the most efficient extracts. Ethanol and methanol extracts for all plants in this study showed higher antibacterial activity compared to aqueous extracts. Among the studied plant extracts, T. spicata extracts showed the best antibacterial effect for MRSA as they act as bacteriocidal agents at concentration range (0.781-6.25) mg/ml. Fractionation and characterization of T. spicata active components may enhance the pharmaceutical industry of new drugs against MRS

Role of Potassium Ions Quantum Tunneling in the Pathophysiology of Phantom Limb Pain

(1) Background: multiple theories were proposed to explain the phenomenon of phantom limb pain (PLP). Nevertheless, the phenomenon is still shrouded in mystery. The aim of this study is to explore the phenomenon from a new perspective, where quantum tunneling of ions, a promising field in medical practice, might play a major role. (2) Methods: investigators designed a quantum mathematical model based on the Schr&ouml;dinger equation to examine the probability of potassium ions quantum tunneling through closed membrane potassium channels to the inside of phantom axons, leading to the generation of action potential. (3) Results: the model suggests that the probability of action potential induction at a certain region of the membrane of phantom neurons, when a neuron of the stump area is stimulated over 1 mm2 surface area of the membrane available for tunneling is 1.04 &times; 10&minus;2. Furthermore, upon considering two probabilities of potassium channelopathies, one that decreased the energy of the barrier by 25% and another one by 50%, the tunneling probability became 1.22 &times; 10&minus;8 and 3.86 &times; 10&minus;4, respectively. (4) Conclusion: quantum models of potassium ions can provide a reliable theoretical hypothesis to unveil part of the ambiguity behind PLP

Screening of anticancer potential of leaf aqueous extract from Pulicaria incisa growing wild in Palestine

402-408The anticancer potential of Pulicaria incisa aqueous extract was estimated by measuring its cytotoxic and cytostatic effect on human cervical cancer (Hela), human colorectal adenocarcinoma (HT-29), and skin melanoma cancer (B16–F1) cell lines. This effect was investigated by the exposure of cancer cell lines to the aqueous extract of P. incisa at different concentrations (5, 2.5, 1.25, 0.625, 0.3215 mg/mL) for 24 and 72 hours. The results showed that the studied extract inhibited the growth of the various cell lines, eventually leading to cell death, as shown by both MTT and LDH assays. The extract of P. incisa displayed the strongest cytotoxic effect against HT-29 cells at high concentrations at which viability was nearly zero %, while the strongest cytostatic effect of the prepared extract was on the B16–F1 cells at high concentrations. Nonetheless, P. incisa extract gave exciting results on Hela cells with a cytotoxic effect at high concentrations and a cytostatic effect at low concentrations. In conclusion, the cytotoxic and cytostatic effect of P. incisa aqueous extract against the three cell lines is due to the presence of several phytochemicals. So, using this plant species as a source for antitumor agents alone or in combination with other agents for cancer treatment is proposed

A Comparative Analysis of the Effect of Carbonaceous Nanoparticles on the Physicochemical Properties of Hybrid Polyethersulfone Ultrafiltration Membranes

Numerous studies have been previously reported on the use of nanoscale carbonaceous fillers, such as multi-walled carbon nanotubes (MWCNTs) and graphene oxide (GO), in polymeric ultrafiltration (UF) membranes; however, no insight has been clearly reported on which material provides the best enhancements in membrane performance. In this study, a comparative analysis was carried out to establish a comprehensible understanding of the physicochemical properties of hybrid polyethersulfone (PES) UF membranes incorporated with MWCNTs and GO nanoparticles at various concentrations. The hybrid membranes were prepared via the non-solvent-induced phase separation process and further characterized by field emission scanning electron microscopy and atomic force microscope (AFM). The AFM images showed homogeneous membrane surfaces with a reduction in the membrane surface roughness from 2.62 nm for bare PES to 2.39 nm for PES/MWCNTs and to 1.68 nm for PES/GO membranes due to improved hydrophilicity of the membranes. Physicochemical properties of the hybrid PES membranes were assessed, and the outcomes showed an enhancement in the porosity, pore size, water contact angle, and water permeability with respect to nanoparticle concentration. GO-incorporated PES membranes exhibited the highest porosity, pore size, and lowest contact angle as compared to PES/MWCNTs, indicating the homogeneous distribution of nanoparticles within the membrane structure. PES/MWCNTs (0.5 wt.%) and PES/GO (1.0 wt.%) hybrid membranes exhibited the highest water flux of 450.0 and 554.8 L m&minus;2 h&minus;1, respectively, at an applied operating pressure of 1 bar. The filtration and antifouling performance of the PES hybrid membranes were evaluated using 50 mg L&minus;1 of humic acid (HA) as a foulant at pH = 7. Compared to the bare PES membrane, the MWCNTs and GO-incorporated PES hybrid membranes exhibited enhanced permeability and HA removal. Moreover, PES/MWCNTs (0.5 wt.%) and PES/GO (1 wt.%) hybrid membranes reported HA rejection of 90.8% and 94.8%, respectively. The abundant oxygen-containing functional groups in GO-incorporated PES membranes resulted in more hydrophilic membranes, leading to enhanced permeability and fouling resistance. The antifouling properties and flux recovery ratio were improved by the addition of both nanoparticles. Given these findings, although both MWCNTs and GO nanoparticles are seen to notably improve the membrane performance, PES membranes with 1 wt.% GO loading provided the highest removal of natural organic matter, such as HA, under the same experimental conditions

Exploring Factors Affecting Graduate Students&rsquo; Satisfaction toward E-Learning in the Era of the COVID-19 Crisis

Background: Shifting the educational system from a traditional to an online context during COVID-19 necessitated several considerations to assure students&rsquo; satisfaction with e-learning. Aim: This study aims to explore the factors influencing students&rsquo; satisfaction with e-learning during the COVID-19 crisis. In particular, it tests multiple mediations, student factors, and system quality between students&rsquo; satisfaction and each course evaluation and instructor&rsquo;s performance. Methodology: In this cross-sectional study, 258 undergraduate and postgraduate students enrolled in online courses at multiple Malaysian universities were recruited using non-probabilistic purposive sampling. Data were collected using a questionnaire that assessed four factors that influenced students&rsquo; satisfaction with e-learning during the COVID-19 crisis (i.e., instructor performance, course evaluation, student factors, and system quality) and analyzed using the partial least squares route structural equation modelling (PLS-SEM). Results: The results indicated that the four factors were significantly associated with students&rsquo; satisfaction with e-learning during COVID-19. Student factors and system quality were the most factors predicting students&rsquo; satisfaction with e-learning. Findings indicate statistically significant relationships between the instructor&rsquo;s performance, student factors, course evaluation, and system quality on students&rsquo; satisfaction. Furthermore, the results depict that both course evaluation and system quality serially mediate the relationship between instructors&rsquo; performance and students&rsquo; satisfaction. Conclusion: This study finds that improving and enhancing student factors and system quality is critical for students&rsquo; satisfaction with e-learning. Furthermore, e-learning platforms should contain new advances of computer-mediated technologies that enable collaboration, which is a critical factor in the success of e-learning systems