Lime peel extract induced NiFe2O4 NPs: Synthesis to applications and oxidative stress mechanism for anticancer, antibiotic activity

Nanobiotechnology, joined with green science, has incredible potential for the advancement of novel and important products that benefit human health, climate, and industries. Green chemistry of materials from synthesis to diverse biomedical applications is a talk of town in today's sustainable ideal world. Green synthesized nickel ferrites nanoparticles via biogenic lime peel extract (LPE) are investigated with precision and complete trail has been reported as multiple efficacies. The fcc crystal structure with the crystallite size (31 nm) were accessed by the XRD, magnetic properties using VSM, and FTIR for the functional group analysis of NiFe2O4 nanoparticles mediated by Lime peel extract (NiFe2O4@LPE NPs). From TEM and SEM analysis the average diameter of the NPs was observed in the range of 31-35 nm. In 3D view, the surface morphology was analyzed by the AFM. NiFe2O4@LPE NPs were used to assess cytotoxicity and cellular morphological alterations in In Vitro cervical cancerous cells (HeLa). Nanosized NiFe2O4@LPE accompanied the considerable NPs topology induced dose dependent MMP in HeLa cells unlike the previous interpretation of controlled metabolism anticancer activity for HeLa cancerous cells. Therefore, it is referred by oxidative stress and reduction phenomena for anticancer effects and inactivation of carcinogen. Moreover, Antioxidant DPPH radical scavenging method and antibacterial Bacillus subtilis, Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus activity were observed in the synthesized nickel ferrites NPs. (c) 2022 The Author(s). Published by Elsevier B.V. on behalf of King Saud University. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).</p

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Physiological Activity, Nutritional Composition, and Gene Expression in Apple (Malus domestica Borkh) Influenced by Different ETc Levels of Irrigation at Distinct Development Stages

Managing irrigation efficiently is paramount given the uncertainty in the future availability of water and rising demand for this resource. Scheduled irrigation significantly influences vegetative growth through improving crop physiology and nutrient uptake and use efficiency. Influence of different irrigation treatments (100%, 75%, and 50% volume of Class A pan evapotranspiration) applied at four different phenological stages (flowering and fruit set (C1), fruit growth stage (C2), pre-harvest stage (C3), and throughout the growing season (C4)) through drip along with a control (rainfed) on leaf physiology, nutrient content, and uptake through gene expression was studied on Super Chief Sandidge variety raised on M9T337 (5 and 6 years old) grown at a spacing of 1.5 × 3 m (2222 plants/ha) under high density condition of Kashmir Himalayan range of India. A comparison of data reveals that drip irrigation at 100% Crop evapotranspiration (ETc) increased leaf area by 60% compared to rainfed conditions. Leaf area significantly increased in plants irrigated throughout the growing season (C4) and during flowering and fruit set stage (C1). Irrigation amount likely does not have any influence on leaf development after the fruit growth stage. Stomatal opening and their size greatly vary from no irrigation to optimum irrigation in these plants. High density apple trees exposed to optimum irrigation levels (100% and 75% ET) had significantly higher concentrations of nutrients (N, P, and K) in their leaf tissues. The concentration of Ca and Mg content in leaf tissues are greatly influenced by the optimum supply of water during the early growth stages of apple growth. The availability of water significantly influences nutrient transporter gene expression and thus nutrient uptake by regulating such transporter genes. It is therefore observed that proper irrigation during C1 and stage C2 stage are the critical growth stages of apple for optimum leaf physiological activity and proper nutrient uptake

Soil Microbiome: A Treasure Trove for Soil Health Sustainability under Changing Climate

Climate change imprints on soil are projected primarily through the changes in soil moisture and surge in soil temperature and CO2 levels in response to climate change and is anticipated to have varying impacts on soil characteristics and processes that are instrumental in the restoration of soil fertility as well as productivity. Climate change encompasses a major concern of sharing its impact on the stability and functionality of soil microbiome and is characterized by one or more chief stability metrics encircling resistance, resilience, and functional redundancy. Nevertheless, the explorations over the past years have unveiled the potential of microbial interventions in the regeneration of soils or assurance of perked-up resilience to crops. The strategies involved therein encompass harnessing the native capability of soil microbes for carbon sequestration, phyto-stimulation, bio fertilization, rhizo-mediation, biocontrol of plant pathogens, enzyme-mediated breakdown, antibiosis, prompting of anti-oxidative defense mechanism, exudation of volatile organic compounds (VOCs) and induced systemic resistance (ISR) response in the host plant. However, the short storage and shelf-life of microbe-based formulations stay a significant constraint and rigorous efforts are necessary to appraise their additive impact on crop growth under changing climate scenarios

Soil Quality Index as Affected by Integrated Nutrient Management in the Himalayan Foothills

Soil quality assessment serves as an index for appraising soil sustainability under varied soil management approaches. Our current investigation was oriented to establish a minimum data set (MDS) of soil quality indicators through the selection of apt scoring functions for each indicator, thus evaluating soil quality in the Himalayan foothills. The experiment was conducted during two consecutive years, viz. 2016 and 2017, and comprised of 13 treatments encompassing different combinations of chemical fertilizers, organic manure, and biofertilizers, viz. (i) the control, (ii) 20 kg P + PSB (Phosphorus solubilizing bacteria), (iii) 20 kg P + PSB + Rhizobium, (iv) 20 kg P + PSB + Rhizobium+ FYM, (v) 20 kg P + 0.5 kg Mo + PSB, (vi) 20 kg P + 0.5 kg Mo + PSB + Rhizobium, (vii) 20 kg P + 0.5 kg Mo + PSB + Rhizobium + FYM, (viii) 40 kg@ P + PSB, (ix) 40 kg P + PSB + Rhizobium, (x) 40 kg P + PSB + Rhizobium+ FYM, (xi) 40 kg P + 0.5 kg Mo + PSB, (xii) 40 kg P + 0.5 kg Mo + PSB + Rhizobium, and (xiii) 40 kg P + 0.5 kg Mo + PSB + Rhizobium + FYM. Evaluating the physical, chemical, and biological indicators, the integrated module of organic and inorganic fertilization reflected a significant improvement in soil characteristics such as the water holding capacity, available nitrogen, phosphorus, potassium, and molybdenum, different carbon fractions and soil biological characteristics encircling microbial biomass carbon (MBC), and total bacterial and fungal count. A principal component analysis (PCA) was executed for the reduction of multidimensional data ensued by scoring through the transformation of selected indicators. The soil quality index (SQI) established for different treatments exhibited a variation of 0.105 to 0.398, while the magnitude of share pertaining to key soil quality indicators for influencing soil quality index encircled the water holding capacity (WHC), the dehydrogenase activity (DHA), the total bacteria count, and the available P. The treatments that received an integrated nutrient package exhibited a higher SQI (T10—0.398; T13—0.372; T7—0.307) in comparison to the control treatment (T1—0.105). An enhanced soil quality index put forth for all organic treatments reflected an edge of any conjunctive package of reduced synthetic fertilizers with prime involvement of organic fertilizers over the sole application of inorganic fertilizers

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit