Dosage form preference consultation study in children and young adults:paving the way for patient-centred and patient-informed dosage form development

Objectives: The current study aims to evaluate dosage form preferences in children and young adults together with identifying the key pragmatic dosage form characteristics that would enable appropriate formulation of orally disintegrating tablets (ODTs). Methods: International, multisite, cross-sectional questionnaire of children and young adults aged from 6 to 18 years. Eligibility was based on age, ability to communicate and previous experience in taking medications. The study was carried out at three locations: the UK, Saudi Arabia and Jordan. The questionnaire instrument was designed for participant self-completion under supervision of the study team.Results 104 questionnaires were completed by the study cohort (n=120, response rate 87%). Results: showed that ODTs were the most preferred oral dosage forms (58%) followed by liquids (20%), tablets (12%) and capsules (11%). The preferred colours were pink or white while the preferred size was small (<8 mm) with a round shape. With regard to flavour, strawberry was the most preferred (30.8%), while orange was the least preferred (5.8%). The results also showed that the most important physical characteristics of ODTs were disintegration time followed by taste, size and flavour, respectively. Conclusions: The results of our study support the WHO's claim for a shift of paradigm from liquid towards ODTs dosage forms for drug administration to young children older than 6 years. Data from this study will also equip formulators to prioritise development of key physical/performance attributes within the delivery system

Prevalence of Comorbidities Associated With Type 2 Diabetes Mellitus In Ksa: A Cross-Sectional Study

Objective: To determine the prevalence of comorbidities associated with type 2 diabetes mellitus among the Saudi adult population. Methods: A cross-sectional study design will be employed to investigate the prevalence of comorbidities associated with Type 2 Diabetes Mellitus (T2DM) within the Kingdom of Saudi Arabia (KSA) population. This design allows for the collection of data at a single point in time, providing insights into the existing relationship between T2DM and comorbidities.Results: The study included 601 participants. The most frequent body mass index BMI value among study participants was overweight 25-29.9 kg/m2 (n= 196, 33%), followed by Normal 18.5-24.9 kg/m2 (n= 177, 29%). The frequent gender among study participants was male years (n= 356, 59%) and female (n= 245, 41%). The most frequent age among study participants was 40-50 years (n= 145, 24%), followed by 18-28 years (n= 140, 23%). The most frequent marital status among study participants was married (n= 360, 60%), followed by single (n= 160, 27%). The perceived physical activity per week among study participants, most of whom did not do any activity (n=231,38%) followed one-time activity (n=98,16%). Conclusion: The results showed that most of the study participants were overweight according to their BMI. The majority of patients had normal blood pressure. Most of the participants suffer from diabetes. In addition, most of the participants do not do any activity, and the majority of participants are non-smokers

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Effect of drinking parsley leaf tea on urinary composition and urinary stones′ risk factors

To investigate the effect of parsley leaf tea on urine composition and the inhibitors of urinary tract stones formation, we studied 20 healthy volunteers who were divided into two groups: the first group of 10 subjects drank daily 1,200 mL of parsley leaf tea for 2 weeks, while the second group drank at least 1,200 mL daily of bottled water for the same period. This was followed by a 2-week "washout" period before the two groups were crossed over for another 2 weeks. During the experimental phase, 24-h urine samples were collected at baseline, on day 14, and at the end of the 6-week period and different urinary parameters were measured and analyzed statistically. We found no significant difference in the urine volume, pH, sodium, potassium, chloride, urea, creatinine, phosphorus, magnesium, uric acid, cystine, or citric acid. Further research is needed to evaluate the effects of parsley leaf tea on urinary parameters in healthy and stone-forming patients

Biochemical and Physiological Responses of Thermostable Wheat Genotypes for Agronomic Yield under Heat Stress during Reproductive Stages

Wheat is a globally important crop used as a main staple food in various countries of the world. The current study was conducted with the objective to evaluate the effect of a high temperature (HT) on osmolytes (starch, sucrose, total soluble sugars, total soluble proteins and proline), physiological parameters (Chl-a, Chl-b, photosynthesis rate, transpiration rate and stomatal conductance), antioxidant enzymes (superoxide dismutase, catalase and peroxidase) and agronomic traits (flag leaf area, spike length, and thousand grain weight) during the grain filling and anthesis stages of wheat cultivars (Fakhr-e-Bhakar, Raj-3765, Jimai-22 and Bayraktar-2000) collected from different regions of the world. Separate experiments for both stages were conducted in a glasshouse and treated with two different temperature regimes, i.e., optimum (OT) (24 °C day; 14 °C night) and high temperature (HT) (32 °C day; 22 °C night) in RCBD for two weeks. The data for osmolytes, antioxidant enzymes and physiological contents were collected at days 3, 5, 7, 9 and 13 after the start of plant stress, while the agronomic traits were collected at maturity. The data obtained were subjected to a statistical analysis using the statistix8.1 and R-program. HT stress significantly reduced all the traits except for the membrane damage, transpiration rate, proline and total soluble sugars, whose values increased considerably in the genotype Bayraktar-2000. However, under both regimes of temperature Fakhr-e-Bhakkar showed a high tolerance against HT stress, as revealed by physiological, biochemical and agronomic evaluations. Moreover, correlation, PCA and heat map analyses indicated that all types of traits are significantly interconnected in determining the crop potential to sustain its growth under HT stress

Utilization of scrotal orchidopexy for palpable undescended testes among surgeons

Introduction: Scrotal orchidopexy for palpable undescended testicle (UDT) has received attention in the last decade due to its lower morbidity. This study was conducted to determine the frequency and factors related to the use of the scrotal approach in the surgical treatment of palpable UDT among surgeons. Methods: An observational cross-sectional study was carried out using an online survey, which was sent to different pediatric urologists, pediatric surgeons, and urologists groups. The survey consisted of questions on demographics as well as surgeons opinions and experience toward scrotal orchidopexy. Results: Of 163 respondents, 57 (35.0%) were pediatric surgeons, 98 (60.1%) were pediatric urologists, and 8 (4.9%) were urologists. There were 86 respondents (52.8%) who used the scrotal orchidopexy approach for UDT at any time in their practice. Pediatric urologists tended to use the scrotal orchidopexy approach for UDT more significantly than others (P < 0.001). There were significantly more scrotal orchidopexies for UDT performed by the pediatric urologists throughout their practice and per year compared to others, respectively (P < 0.001). Fifty-two respondents (31.9%) claimed that scrotal orchidopexy is not a good option for their patients, while seven respondents (4.3%) claimed that the procedure was hard to perform. Discussion: Based on the results of this study, we believe that there is a discrepancy in the reported advantages and success rate of scrotal orchidopexy in the published literature and the utilization of such an approach among surgeons managing palpable UDT in children. Conclusion: Scrotal orchidopexy is an underutilized approach in the management of palpable UDT in children. Only 52.8% of our respondents used it for UDT. One of the main reasons why scrotal orchidopexy is underutilized is due to the surgeons' perception that scrotal orchidopexy is not the procedure of choice for their patients and their unfamiliarity with the procedure

A novel deep learning‐based single shot multibox detector model for object detection in optical remote sensing images

Abstract Remote sensing image object detection is widely used in civil and military fields. The important task is to detect objects such as ships, planes, airports, harbours and so on, and then it can obtain object category and position information. It is of great significance to use remote sensing images to observe the densely arranged and directional targets such as cars and ships parked in parking lots and harbours. The object detection task mainly includes object localization and classification. Remote sensing images contain large number of small objects and dense scenes due to the long shooting distance and wide coverage. Small objects occupy few pixels in the image, and they are easily miss‐detected. In dense scenes, the overlapping part of each object is large, so it is easy to detect objects repeatedly. The traditional small object detection methods deliver low accuracy and take long time. Therefore, object detection is very challenging. We put forward a novel deep learning‐based single shot multibox detector (SSD) model for object detection. First, we propose an improved inception network to optimize SSD to strengthen the small object feature extraction ability (FEA) in the shallow network. Second, the feature pyramid network is modified to enhance the fusion effect. Third, the deep feature fusion module is designed to improve the FEA of the deep network. Finally, the extracted image features are matched with candidate boxes with different aspect ratios to perform object detection and location with different scales. Experiments on DOTA show that the proposed algorithm can adapt to the remote sensing object detection in different backgrounds, and effectively improve the detection effect of remote sensing objects in complex scenes