Cotton fabric loaded with ZnO nanoflowers as a photocatalytic reactor with promising antibacterial activity against pathogenic E. coli

Nanofinishing is the process by which ultrafine dispersion of nanomaterials is applied to a textile for the development of functionalities. The utilization of nanometal oxides as antimicrobial agents have shown a substantial antimicrobial property in cotton. In the present study, previously synthesized powder containing ZnO nanoflowers (ZnO NFs) was characterized for morphology, surface composition, roughness, and charge using Transmission electron microscopy (TEM), Scanning transmission electron microscopy (STEM), Atomic force microscopy(AFM) and Zeta potential. Optical properties of crystalline ZnO were determined by Photoluminescence (PL), Diffused reflectance Spectroscopy (DRS), and bandgap energy determination. Highly crystalline, ZnO NFs bearing crystal defects and high surface charge were loaded onto the pristine cotton by a dip coating method using Triton X-100 as dispersant and iSys MTX fabric binder. The pristine cotton fabric of 125 g/m2 was nano finished by loading 20,42 and 58 µg/cm2 (1–3 dip cycles) ZnO NFs respectively. The loading of ZnO NFs onto the surface of cotton fabric was confirmed by SEM and used for antibacterial activity against E. coli as a photocatalytic reactor. The prepared samples were irradiated with a UV lamp of λmax = 254 nm (15 min, 30 min, 45 min) and D65 artificial sunlight (60 min, 120 min, 180 min) to investigate their photocatalytic activity against pathogenic E. coli using modified Breed Smear’s method. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of ZnO NFs@ cotton were determined as 19.53 µg/ml and 39.06 µg/ml respectively after exposure to UV light. After exposure to sunlight MIC and MBC observed were higher i.e. 156.25 µg/ml and 312.5 µg/ml respectively showing lesser activity in sunlight as compared to ionizing UV radiations. To verify the photocatalytic activity, hydroxyl radicals generated by ZnO NFs@ cotton were also determinedtime-resolved PL on exposure to a UV lamp and D65 artificial sunlight. This nano-finished cotton is a promising candidate to be used as a medical textile with high antibacterial activity even after 20 washing cycles with only a 5% decrease in efficiency

Systematic review and meta-analysis of diagnostic delay in axial spondyloarthritis

Abstract Background. Delay to diagnosis in axial spondyloarthritis (axSpA) is longer than many other rheumatic diseases. Prolonged delay has been shown to associate with poorer outcomes including functional impairment and quality of life. Our aims were to describe 1) global variation in delay to diagnosis, 2) factors associated with delay, and 3) differences in diagnostic delay between axSpA and psoriatic arthritis (PsA).Methods. We searched Medline, PubMed, EMBASE and Web of Science using a predefined protocol in accordance with PRISMA guidelines. Delay to diagnosis was defined as years between age at symptom onset and age at diagnosis. We pooled mean diagnostic delay using random-effects inverse variance meta-analysis. We examined variations in pooled estimates using pre-specified subgroup analyses and sources of heterogeneity using meta-regression.Results. A total of 64 studies reported mean diagnostic delay in axSpA patients. The pooled mean delay was 6.7 years (95% confidence interval 6.2 to 7.2) with high levels of heterogeneity. Delay to diagnosis did not improve over time when stratifying results by year of publication. Studies from high-income countries (defined by the World Bank) reported longer delay than those from middle-income countries. Factors consistently reported to be associated with longer delay were: lower education levels, younger age at symptom onset and absence of extra-articular manifestations. Pooled estimate for diagnostic delay from 8 PsA studies was significantly shorter, at 2.6 years (95%CI 1.6 to 3.6). Conclusion. For axSpA patients, delay to diagnosis remains unacceptably prolonged in many parts of the world, although some countries have reported remarkable improvements. Patient factors (education) and disease presentation (age at onset and extra-articular manifestations) should inform awareness campaigns to improve delay. Targets for improvement should aim to resemble delays in other spondyloarthritis patients.</jats:p

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