19 research outputs found
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Crown ethers: novel permeability enhancers for ocular drug delivery?
Crown ethers are cyclic molecules consisting of a ring containing several ether groups. The most common and important members of this series are 12-crown-4 (12C4), 15-crown-5 (15C5), and 18-crown-6 (18C6). These container molecules have the ability to sequester metal ions and their complexes with drugs are able to traverse cell membranes. This study investigated 12C4, 15C5 and 18C6 for their ability to increase solubility of ocular drugs and enhance their penetration into the cornea. Phase solubility analysis determined crown ethersâ ability to enhance the solubility of riboflavin, a drug used for the therapy of keratoconus, and these solutions were investigated for ocular drug permeation enhancing properties. Atomic absorption spectroscopy demonstrated crown ether solutions ability to sequester Ca2+ from corneal epithelia and crown ether mediated adsorption of riboflavin into the stroma was investigated. Induced corneal opacity studies assessed potential toxicity of crown ethers. Crown ethers enhanced riboflavinâs aqueous solubility and its penetration into in vitro bovine corneas; the smaller sized crown ethers gave greatest enhancement. They were shown to sequester Ca2+ ions from corneal epithelia, doing so loosens cellular membrane tight junctions thus enhancing riboflavin penetration. Induced corneal opacity was similar to that afforded by benzalkonium chloride and less than is produced using polyaminocarboxylic acids. However, in vivo experiments performed in rats with 12C4 did not show any statistically significant permeability enhancement compared to enhancer-free formulation
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 Hirschsprungâs 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 Hirschsprungâs 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 36â39) and median bodyweight at presentation was 2·8 kg (2·3â3·3).
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;
pâ€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 1·88â4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59â2·79], p<0·0001), sepsis at presentation (1·20
[1·04â1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4â5 vs ASA 1â2, 1·82 [1·40â2·35], p<0·0001; ASA 3 vs ASA 1â2, 1·58, [1·30â1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02â1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41â2·71], p=0·0001; parenteral nutrition 1·35, [1·05â1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47â0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50â0·86], p=0·0024) or percutaneous central line (0·69 [0·48â1·00], 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
HOGYAN LEHET ĂLETET ADNI A RĂGI GAZDASĂGI FUNKCIĂKNAK?
Ăden az Arab fĂ©lsziget csĂșcsĂĄn, a Vörös tenger bejĂĄratĂĄnĂĄl helyezkedik el, nĂ©gy mĂ©rföldre a kelet-nyugati hajĂłzĂĄsi ĂștvonaltĂłl. TermĂ©szetes mĂ©lyvizƱ kikötĆje hagyomĂĄnyosan a vilĂĄg egyik legforgalmasabb ĂŒzemanyag felvevĆ helyĂ©vĂ© tette, szolgĂĄlva a hajĂłk Szuezi csatornĂĄn valĂł ĂĄthaladĂĄsĂĄt.
Az Ăłkori Ăden, a karavĂĄnutak talĂĄlkozĂĄsĂĄnĂĄl az Arab fĂ©lsziget csĂșcsĂĄn a fƱszer- Ă©s a tömjĂ©nkereskedelem jelentĆs központja volt mĂĄr az i.e. 7. szĂĄzadban. A modern idĆkben (az 1839 Ă©s 1967 közötti idĆszakban) a britek szĂĄmĂĄra az arab vilĂĄg elsĆszĂĄmĂș kereskedelmi kikötĆje volt, Ă©s a vilĂĄg negyedik legfontosabb kikötĆjĂ©nek soroltĂĄk egykor. A fĂ©nykorĂĄban, az 1950-es Ă©vekben, napi 40-50 hajĂł kötött ki Ăden kikötĆjĂ©ben, amivel New York utĂĄn a mĂĄsodik legforgalmasabb kereskedelmi kikötĆ volt.
Jemen 1990-ben törtĂ©nt egyesĂtĂ©sĂ©t követĆen, Ăden elhelyezkedĂ©sĂ©bĆl adĂłdĂł elĆnyök kihasznĂĄlĂĄsĂĄra szabad kereskedelmi övezettĂ© nyilvĂĄnĂtottĂĄk a vĂĄrost, egyben Jemen gazdasĂĄgi Ă©s kereskedelmi fĆvĂĄrosĂĄvĂĄ is tĂ©ve azt. A jemeni kormĂĄny jelentĆs beruhĂĄzĂĄsokat hajtott vĂ©gre a jemeni kikötĆ Ă©s reptĂ©r bĆvĂtĂ©sĂ©re, valamint azok szolgĂĄltatĂĄsainak fejlesztĂ©sĂ©re, tovĂĄbbĂĄ a vĂĄros infrastruktĂșrĂĄjĂĄnak megĂșjĂtĂĄsĂĄra is. A kormĂĄny kiemelt kezdemĂ©nyezĂ©se volt a PPP keretĂ©ben megvalĂłsĂtott Ădeni KontĂ©ner TerminĂĄl (ACT) lĂ©trehozĂĄsa, amely 1999 mĂĄrciusĂĄban nyĂlt meg. A terminĂĄl a gazdasĂĄgi tevĂ©kenysĂ©gek jelentĆs expanziĂłjĂĄt eredmĂ©nyezte az ĂĄdeni kikötĆben. Ăden szabad kereskedelmi övezettĂ© nyilvĂĄnĂtĂĄsa, az ACT megĂ©pĂtĂ©se, valamint az infrastruktĂșra fejlesztĂ©sek talĂĄlkozott mind a hazai, mind a nemzetközi befektetĆk Ă©rdeklĆdĂ©sĂ©vel a mƱködĂ©s helyĂ©nek a vĂĄrosba törtĂ©nĆ helyezĂ©sĂ©re, tovĂĄbbĂĄ a szabad kereskedelmi övezet elĆnyeinek Ă©s a kikötĆi szolgĂĄltatĂĄsok kihasznĂĄlĂĄsĂĄra.
2001 decemberĂ©ben Ăden hozzĂĄkezdett a helyi gazdasĂĄgfejlesztĂ©si stratĂ©gia megformĂĄlĂĄsĂĄhoz. A stratĂ©gia cĂ©lja a magĂĄnszektor termelĂ©kenysĂ©gĂ©nek tĂĄmogatĂĄsa, az ĂŒzleti környezet javĂtĂĄsa, beleĂ©rtve az Ășj magĂĄnbefektetĂ©sek szĂĄmĂĄra vonzĂłvĂĄ tĂ©telt, a vĂĄllalkozĂĄsok mƱködĂ©si kilĂĄtĂĄsainak fejlesztĂ©se. Az elmĂșlt nĂ©hĂĄny Ă©vben jelentĆs figyelem irĂĄnyult Ăden vĂĄrosra Ă©s tanulmĂĄny kĂ©szĂŒlt rĂłla, ĂĄtdolgozott, megĂșjĂtott tervek a helyi gazdasĂĄg fejlesztĂ©sĂ©rĆ, klaszterelemzĂ©ssel, valamint tĆkebefektetĂ©si tervvel az elmĂșlt öt Ă©vben. Ipari szakĂ©rtĆk rĂ©szvĂ©telĂ©vel Ă©s ĂĄltaluk nyĂșjtott adatok alapjĂĄn megbecsĂŒltĂ©k a meglĂ©vĆ gazdasĂĄgi Ă©s fizikai vagyont, Ă©s hĂĄrom magas növekedĂ©si potenciĂĄlĂș stratĂ©giai terĂŒletet azonosĂtottak: kikötĆi, tengeri szolgĂĄltatĂĄsokat, a vendĂ©glĂĄtĂĄst Ă©s turizmust, valamint a feldolgozĂłipart.
------------------------------------------------------ Adenâs position at the tip of the Arabian Peninsula near the entrance to the Red Sea, only four miles from the main East-West shipping route, and its natural deep-water harbor have historically made the city one of the busiest refueling stations in the world, servicing most ships that pass through the Suez Canal.
Aden is an ancient city and its status as a trading center dates back to the seventh century BC when it served as a station for merchants of spice and incense and a passageway for caravans traveling over the Arabian peninsula. In modern times (1839-1967), Aden was the primary trading post in the Arab region for the British and at one point ranked fourth among the world most important ports. At its peak, in 1950, the number of vessels that entered the port of Aden reached between 40 and 50 a day, putting Aden in second place after New York as the busiest port.
After the unification of Yemen in 1990, and to capitalize on Adenâs location advantage, the city was declared a free trade zone, which further enhanced its role as the economic and commercial capital of Yemen. Since then, the Government of Yemen has invested significantly in the expansion of port and airport facilities, and in upgrading the cityâs infrastructure. The governmentâs flagship initiative, through a public-private partnership, was the Aden Container Terminal (ACT), which opened for business in March 1999. The ACT stimulated a significant expansion of activities in the Port of Aden. Indeed, the declaration of Aden as a Free Zone, the construction of ACT, and the infrastructure investments have been met with growing interest from both national and international investors to locate operations in the city and capitalize on the free zone and port facilities.
In December 2001, Aden began the formulation of a Local Economic Development Strategy. The objective of the Strategy is to support private sector productivity and enhance the business enabling environment, including attraction of new private investment and improving the prospects for business retention. In the last few years, significant attention and study has been directed at the city of Aden â a revised and updated master plan, an assessment of the local economy, a clusters analysis, and a priority capital investment plan have been prepared in the last five years. Through a participatory process, and with input from industry experts, Aden assessed its existing economic and physical assets, and identified three strategic areas with high growth potential â maritime services, hospitality and tourism, and manufacturing industries
A jemeni mezĆgazdasĂĄg helyzete Ă©s jövĆbeni kilĂĄtĂĄsai
A tanulmĂĄny Jemennek, az Arab-fĂ©lsziget dĂ©lnyugati rĂ©szĂ©ben elhelyezkedĆ arab orszĂĄgnak a gazdasĂĄgi kihĂvĂĄsaival foglalkozik, azon belĂŒl is hangsĂșlyosan az agrĂĄrĂĄgazat helyzetĂ©re Ă©s kritikus kĂ©rdĂ©seire összpontosĂtva. Jemen, bĂĄr az Arab-fĂ©lsziget orszĂĄgai közĂŒl egyedĂŒl nem klasszikus âolajĂĄllamâ, ennek ellenĂ©re szĂĄmottevĆ termĂ©szeti erĆforrĂĄsokkal Ă©s kereskedelmi, illetve stratĂ©giai szempontbĂłl kedvezĆ földrajzi adottsĂĄgokkal rendelkezik, mivel a Vörös-tenger Ă©s az Indiai-ĂłceĂĄn közti hajĂłzĂĄsi Ăștvonal kritikus pontja, a Bab el-Mandeb szoros mentĂ©n helyezkedik el. Az orszĂĄg ugyanakkor az utĂłbbi Ă©vtizedekben igen nehĂ©z idĆszakot Ă©lt ĂĄt. A fĂŒggetlensĂ©g megszerzĂ©se Ăłta az orszĂĄg kĂ©t rĂ©szre szakadĂĄsa, majd tĂ©nylegesen mĂĄig sem mƱködĆ ĂșjraegyesĂtĂ©se következett be. Ez stagnĂĄlĂł, romlĂł gazdasĂĄgi körĂŒlmĂ©nyeket Ă©s a jemeni tĂĄrsadalom helyzetĂ©nek tovĂĄbbi gazdasĂĄgi nehĂ©zsĂ©geit okozta. Azonban az utĂłbbi idĆben Jemen gazdasĂĄgi Ă©lĂ©nkĂŒlĂ©sĂ©t szĂĄmos belsĆ Ă©s kĂŒlsĆ tĂ©nyezĆ segĂtette. Ezek között a mezĆgazdasĂĄg infrastrukturĂĄlis Ă©s logisztikai fejlesztĂ©se Ă©s a lakossĂĄg mind nagyobb rĂ©szĂ©nek megĂ©lhetĂ©sĂ©t biztosĂtĂł mezĆgazdasĂĄg fellendĂtĂ©se Ă©s szerkezeti ĂĄtalakĂtĂĄsĂĄnak elĆmozdĂtĂĄsa emlĂthetĆ elsĆsorban. Ehhez szorosan kapcsolĂłdik az ĂĄdeni kikötĆ kiĂ©pĂtĂ©se Ă©s Ăgy a hajĂłzĂĄsi-szĂĄllĂtĂĄsi forgalmĂĄnak ĂșjbĂłli fejlesztĂ©se. TanulmĂĄnyunkban Jemen mezĆgazdasĂĄgi helyzetĂ©nek ĂĄtfogĂł bemutatĂĄsa mellett a kibontakozĂĄsi lehetĆsĂ©geit, kilĂĄtĂĄsait Ă©s a fejlesztĂ©s fĆbb irĂĄnyait kĂvĂĄnjuk elemezni, amelyek között az egyik legjelentĆsebb terĂŒlet a mezĆgazdasĂĄg tovĂĄbbi strukturĂĄlis fejlesztĂ©se. A jemeni agrĂĄrtermelĂ©s helyzetĂ©nek, kilĂĄtĂĄsainak Ă©s problĂ©mĂĄinak ismeretĂ©ben lehetsĂ©ges az ĂĄgazat fejlesztĂ©si irĂĄnyainak meghatĂĄrozĂĄsa. Jelenleg az orszĂĄg komoly mĂ©rtĂ©kben Ă©lelmiszer-behozatalra szorul, ezĂ©rt fontos, hogy szĂŒksĂ©gleteinek mind nagyobb rĂ©szĂ©t belföldön ĂĄllĂtsĂĄk elĆ az Ă©lelmiszer-önellĂĄtĂĄs biztosĂtĂĄsa Ă©rdekĂ©ben. Emellett fontos cĂ©l az is, hogy Jemen egyes hazai termĂ©nyekbĆl, pĂ©ldĂĄul kĂĄvĂ©bĂłl jelentĆs exportĆrrĂ© vĂĄljon a közeljövĆben. A mezĆgazdasĂĄg fejlesztĂ©se a vidĂ©ki foglalkoztatottsĂĄg növelĂ©sĂ©t is cĂ©lozza a bĆvĂŒlĆ belföldi Ă©lelmiszer-ellĂĄtĂĄs helyzetĂ©nek javĂtĂĄsa Ă©s az orszĂĄg exportbevĂ©teleinek diverzifikĂĄlĂĄsa mellett. ------------------ In the study the authors gave an analytic insight to the economic challenges of Yemen, the country which is located in the southwestern part of the Arab peninsula, with special focus on the critical problems of the agricultural sector. Even though Yemen cannot be considered as a typical âoil-stateâ, like other countries in the Arab peninsula , it has significant amount of natural resources , moreover its geopolitical and geo-economic importance derives from its location (Yemen is located by Bab el-Mandeb Strait which is a critical point of the navigation route between the Red Sea and the Indian ocean.) The authors believe that the situation in Yemen, which can be characterized with all negative attributes of a long-lasting civil war, will be reconciliated and the economic policy-makers will then search the alternatives for such a development policy which will be able to lead Yemen out of its critical state towards prosperity. From among the reasonable alternatives, the development of the agricultural sector, including the necessary infrastructure and logistic background, seems to be the most promising, as it could bring about social development by creating a significant number of new jobs, moreover it could contribute to a better domestic food supply and agricultural export revenues by which the costs of food imports could be merely diminished as well
The Self-Stigma of Depression Scale: Translation and Validation of the Arabic Version
Background: Self-stigma may feature strongly and be detrimental for people with depression, but the understanding of its nature and prevalence is limited by the lack of psychometrically validated measures. This study is aimed to validate the Arabic version self-stigma of depression scale (SSDS) among adolescents. Materials and Methods: A cross-sectional study involved 100 adolescents randomly selected. The analyses include face validation, factor analysis, and reliability testing. A testâretest was conducted within a 2-week interval. Results: The mean score for self-stigma of depression among study participants was 68.9 (Standard deviation = 8.76) median equal to 71 and range was 47. Descriptive analysis showed that the percentage of those who scored below the mean score (41.7%) is shown less than those who scored above the mean score (58.3%). Preliminary construct validation analysis confirmed that factor analysis was appropriate for the Arabic-translated version of the SSDS. Furthermore, the factor analysis showed similar factor loadings to the original English version. The total internal consistency of the translated version, which was measured by Cronbach's alphas ranged from 0.70 to 0.77 for the four subscales and 0.84 for the total scale. Testâretest reliability was assessed in 65 respondents after 2 weeks. Cronbach's alphas ranged from 0.70 to 0.77 for the four subscales and 0.84 for the total scale. Conclusions: Face validity, construct validity, and reliability analysis were found satisfactory for the Arabic-translated version of the SSDS. The Arabic-translated version of the SSDS was found valid and reliable to be used in future studies, with comparable properties to the original version and to previous studies