The outcome of ultrasound-guided insertion of central hemodialysis catheter

Objective: To point out our experience and assess the efficacy and safety of real-time ultrasound-guided central internal jugular vein (IJV) catheterization in the treatment of hemodialysis patients. Methods: This retrospective study comprised 150 patients with end-stage renal disease (ESRD) who had real-time ultrasonography (US)-guided IJV HD catheters placed in our hospital between March 2019 and March 2021. Patients were examined for their demographic data, etiology, site of catheter insertion, type (acute or chronic) of renal failure, technical success, operative time, number of needle punctures, and procedure-related complications. Patients who have had multiple catheter insertions, prior catheterization challenges, poor compliance, obesity, bony deformity, and coagulation disorders were considered at high-operative risk. Results: All patients experienced technical success. In terms of patient clinical features, an insignificant difference was observed between the normal and high-risk groups (p-value > 0.05). Of the 150 catheters, 62 (41.3%) were placed in high-risk patients. The first-attempt success rate was 89.8% for the normal group and 72.5% for the high-risk group (p = 0.006). IJV cannulation took less time in the normal-risk group compared to the highrisk group (21.2 ± 0.09) minutes vs (35.4 ± 0.11) minutes, (p < 0.001). There were no serious complications. During the placing of the catheter in the internal jugular vein, four patients (6.4%) experienced arterial puncture in the high-risk group. Two participants in each group got a small neck hematoma. One patient developed a pneumothorax in the high-risk group, which was managed with an intercostal chest tube insertion. Conclusions: Even in the high-risk group, the real-time US-guided placement of a central catheter into the IJV is associated with a low complication rate and a high success rate. Even under US guidance, experience lowers complication rates. Real-time USguided is recommended to be used routinely during central venous catheter insertion

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Engineering Red-Enhanced and Biocompatible Upconversion Nanoparticles

The exceptional optical properties of lanthanide-doped upconversion nanoparticles (UCNPs) make them among the best fluorescent markers for many promising bioapplications. To fully utilize the unique advantages of the UCNPs for bioapplications, recent significant efforts have been put into improving the brightness of small UCNPs crystals by optimizing dopant concentrations and utilizing the addition of inert shells to avoid surface quenching effects. In this work, we engineered bright and small size upconversion nanoparticles in a core&ndash;shell&ndash;shell (CSS) structure. The emission of the synthesized CSS UCNPs is enhanced in the biological transparency window under biocompatible excitation wavelength by optimizing dopant ion concentrations. We also investigated the biosafety of the synthesized CSS UCNP particles in living cell models to ensure bright and non-toxic fluorescent probes for promising bioapplications

Engineering Red-Enhanced and Biocompatible Upconversion Nanoparticles

The exceptional optical properties of lanthanide-doped upconversion nanoparticles (UCNPs) make them among the best fluorescent markers for many promising bioapplications. To fully utilize the unique advantages of the UCNPs for bioapplications, recent significant efforts have been put into improving the brightness of small UCNPs crystals by optimizing dopant concentrations and utilizing the addition of inert shells to avoid surface quenching effects. In this work, we engineered bright and small size upconversion nanoparticles in a core–shell–shell (CSS) structure. The emission of the synthesized CSS UCNPs is enhanced in the biological transparency window under biocompatible excitation wavelength by optimizing dopant ion concentrations. We also investigated the biosafety of the synthesized CSS UCNP particles in living cell models to ensure bright and non-toxic fluorescent probes for promising bioapplications

Lithium-Based Upconversion Nanoparticles for High Performance Perovskite Solar Cells

In this work, we report an easy, efficient method to synthesize high quality lithium-based upconversion nanoparticles (UCNPs) which combine two promising materials (UCNPs and lithium ions) known to enhance the photovoltaic performance of perovskite solar cells (PSCs). Incorporating the synthesized YLiF4:Yb,Er nanoparticles into the mesoporous layer of the PSCs cells, at a certain doping level, demonstrated a higher power conversion efficiency (PCE) of 19%, additional photocurrent, and a better fill factor (FF) of 82% in comparison to undoped PSCs (PCE = ~16.5%; FF = 71%). The reported results open a new avenue toward efficient PSCs for renewable energy applications

Synthesis, Characterization, Computational and Biological Activity of Some Schiff Bases and Their Fe, Cu and Zn Complexes

Four new symmetrical Schiff bases derived from 2,2′-diamino-6,6′-dibromo-4,4′-dimethyl-1,1′-biphenyl or 2,2′-diamino-4,4′-dimethyl-1,1′-biphenyl, and 3,5-dichloro- or 5-nitro-salicylaldehyde, were synthesized and reacted with copper-, iron- and zinc-acetate, producing the corresponding complexes. The Schiff bases and their metal complexes were characterized by 1H-, 13C-NMR, IR and UV-Vis spectroscopy and elemental analysis. The structures of one Schiff base and the two zinc complexes were resolved by X-ray structure determination. Density functional theory (DFT) calculations at the B3LYP/6-31G(d) level of the latter compounds were carried out to optimize and examine their molecular geometries. The biomedical applications of the Schiff bases and their complexes were investigated as anticancer or antimicrobial agents

Knowledge, Attitudes, and Practices of the Population in Jazan Region, Saudi Arabia Regarding Dengue Fever and Its Prevention Measures: A Community-Based Cross-Sectional Study

In previous studies, there was an apparent lack of health education about dengue fever (DF) among the Saudi population. Therefore, we conducted this study to assess the knowledge, attitude, and practices (KAP) about dengue fever among the Jazan region population, which is one of the most prevalent diseases in the region in Saudi Arabia (KSA). This was a cross-sectional and community-based study. The adult population was divided into governorates according to the regions that were close to each other, and then a convenient stratum was selected from each region. Next, random sampling was applied. Data were collected using a self-administered questionnaire. Exclusion criteria were young people (&lt;18 years old) and health workers. Data analysis was performed using descriptive statistics, the Pearson&rsquo;s correlation coefficient, and multiple linear regression. Of the 392 participants in this cross-sectional study, 59.18% were male, 76.28% were aged 18&ndash;35 years, 72.96% had a university degree, and 63% had a monthly income of less than SAR 5000 (USD1 = 3.76). The scores (mean &plusmn; SD) for KAP regarding DF among the responders were 22.77 &plusmn; 7.9, 22.68 &plusmn; 7.24, and 25.62 &plusmn; 9.4, respectively. KAP constructs were positively correlated according to the Pearson&rsquo;s coefficient. In multiple linear regression analysis, males were favorably and substantially linked with attitude score (&beta; = 2.76, p = 0.001) and negatively associated with practice score (&beta; = &minus;2.45, p = 0.023). No-degree participants scored lower on knowledge (&beta; = &minus;2.78, p = 0.003). There is potential for more research in Saudi Arabia to increase the generalizability to reduce the impact of dengue epidemics

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

Background: 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

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality

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