Design and characterization of Lactotransferrin peptide-loaded dextran-docosahexaenoic acid nanoparticles: an immune modulator for hepatic damage

Abstract The primary objective of this research was to create injectable delivery formulations using Lactotransferrin (LTF) peptide-loaded dextran nanoparticles coated with docosahexaenoic acid. These nanoparticles, designated as LLDDNP, underwent a lyophilization process. The study encompassed a comprehensive investigation, including physicochemical characterization, in vivo assessment of biomarkers, and an examination of immune response through cytokine modulation. The zeta potential of LLDDNP was − 24.5 ± 12 mV, while their average particle size was 334.9 z.d.nm. The particles exhibited a conductivity of 2.10 mS/cm, while their mobility in the injectable dosage form was measured at − 3.65 µm cm/Vs. The scanning electron microscopy investigation, the lyophilization processes resulted in discrete particles forming particle aggregations. However, transmission electron microscopy analysis revealed that LLDDNP is spherical and smooth. The thermogram showed that about 95% of LLDDNP's weight was lost at 270 °C, indicating that the particles are extremely thermal stable. The XRD analysis of LLDDNP exhibited clear and distinctive peaks at 2θ angles, specifically at 9.6°, 20.3°, 21.1°, 22°, 24.6°, 25.2°, 36°, and 44.08°, providing compelling evidence of the crystalline nature of the particles. According to proton NMR studies, the proton dimension fingerprint region of LLDDNP ranges from 1.00 to 1.03 ppm. The in vitro release of LTF from LLDDNP was found to follow zero-order kinetics, with a commendable R2 value of 0.942, indicating a consistent and predictable release pattern over time. The in vivo investigation revealed a significant impact of hepatotoxicity on the elevation of various cytokines, including IL-1β, IL-6, IL-8R, TNF-α, IL-2, IL-4, IL-10, and IFN-γ. Additionally, the presence of hepatotoxicity led to an increase in apoptosis markers, namely caspase 3 and caspase 9, as well as elevated levels of liver biomarkers such as CRP, ALP, ALT, and AST. In contrast, the treatment with LLDDNP modulated the levels of all biomarkers, including cytokines level in the treatment group extremely high significant at p < 0.001

Mapping out competencies of emergency department nurses: Its influencing factors and barriers

Introduction: The need to determine the factors affecting nurse competency is to assist determine practical approaches to enhance competency. Aim: The study aims to map the competencies of emergency department (ED) nurses, its influencing factors, and barriers. Subjects and Methods: This study employed a cross-sectional approach conducted at the government hospitals in Hail, including village hospitals. The participants of this study were the 227 ED nurses as a result of convenience sampling. The researchers utilized the Google Form survey to collect the data. The data collection was conducted between August and September 2022. Results: Nurses in this study were highly competent (227/275). Clinical care competency has emerged as the highest competency (3.79 ± 0.646), followed by leadership (3.53 ± 1.053). Those who are 26–30 years old (B = 0.766; P < 0.000); 95% confidence interval (CI) (0.623–0.909) are far better than the other age groups. Furthermore, 5 years and above were competent compared to those with <5 years of experience (B = −1.135; P < 0.000; 95% CI [−1.271–0.998]). Moreover, those who have training in the ED (B = 1.127; P < 0.000; 95% CI [0.588 ± 1.666]) have better competencies than those who have no training in ED. Barriers were that the training was not in line with the ED nurses' needs and lack of leaders' support (92.5%). Conclusion: The ED nurses were highly competent, especially in the clinical care leadership competency. The older age group and <5 years of experience and training with ED were influential to their competency. Barriers were that the training was not in line with the needs of the ED nurses and lack of support from leaders. Study findings suggest that the measurement of competency be continuous to improve the competency of the ED nurses. Training needs assessment specifically in the ED, to be conducted periodically and offer continuous nursing education based on the identified needs of the nurses

Appropriateness of antibiotic prescribing for urinary tract infection in the emergency department of a tertiary care hospital

Background: Urinary tract infections (UTIs) are frequently diagnosed in the Emergency Departments (EDs) in Saudi Arabia. Despite their prevalence, there is a lack of localized data on antibiotic prescribing practices for UTIs in EDs, hampering optimal patient care and antibiotic resistance management. Objective: This study aimed to evaluate the appropriateness of antibiotic prescriptions for UTI patients by examining adherence to treatment guidelines at a tertiary care ED in Saudi Arabia. Methods: A retrospective cohort analysis was performed in UTI patients with ≥18 years of age who were presented to the ED at a tertiary care hospital between January 2022 and January 2023. 179 patients were randomly selected for enrollment, and data related to their demographics, medical history, microbial isolation, administered antibiotics, and incidence of recurrent infections were collected. Results: Ciprofloxacin (38 %), Cefuroxime (26.8 %), and Nitrofurantoin (16.8 %) were the most prescribed antibiotics. The female population accounted for 87.3 % of UTI cases. Notably, 40.7 % lacked microbial growth or data. Inappropriateness was found in 55.3 % of selection, 27.9 % of dosing, and 38.5 % of treatment duration confined to antibiotics in UTI management. Moreover, complicated UTIs rather than duration and indication for antibiotic therapy were independent risk factors for the re-occurrence of UTIs. Conclusions: The study depicted an overall 44.7 % of appropriate antibiotic prescriptions in UTI patients. However, it also highlighted the necessity for tailored interventions and promotional efforts aimed at promoting the rational use of antibiotics in patients, thereby preventing resistance and treatment failure

Resilience and Emotional Intelligence of Staff Nurses during the COVID-19 Pandemic

Although numerous scholars have studied resilience during the COVID-19 pandemic, research exploring its relationship with emotional intelligence is scarce. The aim of this study was to determine the relationship between the resilience and emotional intelligence (EI) of staff nurses during the COVID-19 pandemic. Data for this quantitative correlational study were gathered from the staff nurses of hospitals in the city of Hail, Saudi Arabia. The researchers employed simple random sampling, which yielded 261 staff nurses. Nationality (t = 6.422; p &lt; 0.001) was found to have a significant relationship with resilience. Sex (t = 5.22; p &lt; 0.001), ward assignment (t = 5.22; p &lt; 0.001), age (F = 6.67; p &lt; 0.001), and years of experience (F = 6.67; p &lt; 0.001) revealed significant relationships with emotional intelligence. Resilience had a moderate positive relationship with EI (r = 0.55; p &lt; 0.023), a weak positive relationship with self-emotion (r = 0.21; p &lt; 0.003), and a very strong relationship with emotional appraisal (r = 0.85; p &lt; 0.001). Improving emotional-intelligence skills is critical for assisting nurses during pandemic outbreaks. This can increase their individual and social resilience, while also improving their professional and life outcomes. These research findings suggest that emotional intelligence should be integrated into clinical practice and that EI data should be integrated into decision-making

Design, Characterization, and Immune Augmentation of Docosahexaenoic Acid Nanovesicles as a Potential Delivery System for Recombinant HBsAg Protein

Recombinant HBsAg-loaded docosahexaenoic acid nanovesicles were successfully developed, lyophilized (LRPDNV) and characterized for their physico-chemical properties. The zetapotential (ZP) of LRPDNV was &minus;60.4 &plusmn; 10.4 mV, and its polydispersity (PDI) was 0.201, with a % PDI of 74.8. The particle sizes of LRPDNV were 361.4 &plusmn; 48.24 z. d.nm and 298.8 &plusmn; 13.4 r.nm. The % mass (r.nm) of LRPDNV in a colloidal injectable system was 50, its mobility value was &minus;3.417 &micro;m cm/Vs, while the conductivity of the particles was 0.728 (mS/cm). Transmission electron microscopic (TEM) analysis showed smooth morphological characteristics of discrete spherical LRPDNV. Differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA) of LRPDNV revealed that LRPDNV is thermostable. The X-ray diffraction (XRD) studies showed a discrete crystalline structure of LRPDNV at 2&theta;. Nuclear magnet resonance (NMR) studies (1H-NMR and 13C-NMR spectrum showed the discrete structure of LRPDNV. The immunogenicity study was performed by antibody induction technique. The anti-HBs IgG levels were elevated in Wistar rats; the antibody induction was observed more in the product (LRPDNV) treatment group when compared to the standard vaccine group. The level of antibodies on the 14th and 30th day was 6.3 &plusmn; 0.78 U/mL and 9.24 &plusmn; 1.76 U/mL in the treatment and standard vaccine groups, respectively. Furthermore, the antibody level on the 30th day in the treatment group was 26.66 &plusmn; 0.77 U/mL, and in the standard vaccine group, the antibody level was 23.94 &plusmn; 1.62 U/mL. The LRPDNV vaccine delivery method released HBsAg sustainably from the 14th to the 30th day. The results of this study indicate the successful formulation of DHA nanovesicles which have great potential as an adjuvant system for the delivery of recombinant HBsAg protein

Relationship between the Health Literacy and Self-Medication Behavior of Primary Health Care Clientele in the Hail Region, Saudi Arabia: Implications for Public Health

Background and aim: Because they are unaware of the potential adverse effects of medications, people frequently self-medicate as a form of self-care. This study aimed to investigate the factors associated with health literacy and the propensity to self-medicate among the primary healthcare clientele of the city of Hail, Saudi Arabia. Methods: This research employed a cross-sectional approach with the participation of 383 primary health center clientele of the Hail Region of Saudi Arabia. Participation was enacted via convenience sampling from December 2022 to February 2023. The data were collected using a self-administered questionnaire. The investigation utilized descriptive statistics as well as multiple linear regression and correlation for the data analysis. Results: Participants who were aged 30 years and above, single, had a college degree, were non-Saudi, had a white-collar occupation and received information from the internet/Google/YouTube had a significant relationship (p p p p p < 0.001). Conclusion: Age of 30 years old or above, single status, a college degree, non-Saudi status, white-collar occupation and receiving information from the internet/Google/YouTube were all significant for health literacy. There were also significant relationships with the SMS scores for age, marital status, educational level and occupation. The factors affecting health literacy were older participant age, nationality and the source of information regarding health. Conversely, among the participants, being in the middle-aged group (24–29 years) was a factor that affected their self-medication scores. There was a significant positive correlation between the health literacy screening scale (BRIEF) and the self-medication scale (SMS)

A Unique Presentation Site of Pleomorphic Adenoma in a Young Woman: A Case Report

Summary:. The expression “pleomorphic adenoma” has been used synonymously with mixed cutaneous tumors and chondroid syringomas. It originates from eccrine or apocrine skin, salivary glands, and lacrimal glands. Histologically, it comprises an epithelial-lined glandular component embedded in the cartilaginous, myxomatous, or fibrous stroma. These lesions are usually misdiagnosed because they are extremely rare. It commonly affects middle-aged men and has a slow-growing nature. The usual manifestation is a firm nodular lesion in the periorbital region, particularly at eyelid margins. A unique presentation of this tumor was described in a young woman. The tumor presented as a small, static, nontender lump located at the junction of the superior margin of the left eyebrow and forehead. After a thorough clinical assessment, she underwent a complete surgical excision of the lesion. The most probable preoperative clinical impression at that time was that of a sebaceous cyst. However, histopathological examination revealed it to be a pleomorphic adenoma, which, to our knowledge, has never been reported in the literature at this specific anatomical site. Two years after the procedure, the patient’s follow-up was uneventful, and revealed no recurrence of the lesion. Although its incidence is exceptionally low, it should always be considered in the differential diagnosis of cutaneous lesions in the head, neck, and trunk. Complete surgical excision for histopathological assessment is recommended to rule out malignancy and avoid the frequent issue of local recurrence in cases of benign tumors

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population