Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Synthesis, X-ray Single-Crystal Analysis, and Anticancer Activity Evaluation of New Alkylsulfanyl-Pyridazino[4,5-b]indole Compounds as Multitarget Inhibitors of EGFR and Its Downstream PI3K-AKT Pathway

The alkylation of 3,5-dihydro-4H-pyridazino[4,5-b]indole-4-thione with benzyl bromide, ethyl chloroacetate, and allyl bromide in the presence of potassium carbonate (K2CO3) yielded new alkylsulfanylpyridazino[4,5-b]indole derivatives (i.e., compounds 4–6). Hydrazinolysis of ester 6 resulted in hydrazide 7. The structure of compound 6 was verified by X-ray single-crystal analysis. Among the synthesized compounds, compound 6 exhibited the most promising cytotoxicity toward MCF-7 cells with an IC50 value of 12 µM. It showed potential inhibition activity toward EGFR, PI3K, and AKT in MCF-7 cells, with 0.26-, 0.49-, and 0.31-fold reductions in concentration compared to an untreated control. Additionally, it showed apoptosis-inducing activity in MCF-7 cells (47.98-fold); overall apoptosis increased to 38.87% compared to 0.81% in the untreated control, which disrupted the cell cycle at pre-G1 and S phases. Moreover, compound 6 exhibited good binding affinities toward the tested proteins (EGFR, PI3K, and AKT) and had binding energies ranging from −15.87 to −24.87 Kcal/mol. It also formed good interactions with essential amino acids inside the binding sites. Hence, compound 6 is recommended as an anti-breast cancer chemotherapeutic due to its effects on the EGFR-PI3K-AKT pathway.peerReviewe

Evaluation of the Impact of Two Thiadiazole Derivatives on the Dissolution Behavior of Mild Steel in Acidic Environments

In light of the variety of industrial uses and economic relevance of mild steel, corrosion resistance is a serious topic. Utilization of inhibitors serves as one of the most essential methods for corrosion control. Two thiadiazole compounds, namely, 2-amino-5-(4-bromobenzyl)-1,3,4-thiadiazole (a1) and 2-amino-5-(3-nitrophenyl)-1,3,4-thiadiazole (a2), were synthesized. The structure of the prepared compounds was verified by Fourier transform infrared spectroscopy (FTIR) and proton and carbon-13 nuclear magnetic resonance spectroscopy (1H NMR and 13C NMR). In a 0.50 M H2SO4 solution, the effectiveness of two synthetic thiadiazole derivatives as mild steel corrosion inhibitors were investigated. In this evaluation, various electrochemical methodologies have been utilized, such as potentiodynamic polarization, open circuit potential (OCP), and electrochemical impedance spectroscopy (EIS). The results confirm the efficiency of the inhibition increases by raising concentrations of a1 and a2. The inhibitory behavior was explained by the notion that the adsorption of thiadiazole molecules, a1 and a2, on the surface of mild steel causes a blockage of charge and mass transfer, protecting the mild steel from offensive ions. Furthermore, the synthesized molecules a1 and a2 were analyzed using density functional theory (DFT)

Application of Three Ecological Assessment Tools in Examining Chromatographic Methods for the Green Analysis of a Mixture of Dopamine, Serotonin, Glutamate and GABA: A Comparative Study

The assessment of greenness of analytical protocols is of great importance now to preserve the environment. Some studies have analyzed either only the neurotransmitters, dopamine, serotonin, glutamate, and gamma-aminobutyric acid (GABA), together or with other neurotransmitters and biomarkers. However, these methods have not been investigated for their greenness and were not compared with each other to find the optimum one. Therefore, this study aims to compare seven published chromatographic methods that analyzed the four neurotransmitters and their mixtures using the National Environmental Method Index, Analytical Eco-Scale Assessment (ESA), and Green Analytical Procedure Index (GAPI). As these methods cover both qualitative and quantitative aspects, they offer better transparency. Overall, GAPI showed maximum greenness throughout the analysis. Method 6 was proven to be the method of choice for analyzing the mixture, owing to its greenness, according to NEMI, ESA, and GAPI. Additionally, method 6 has a wide scope of application (13 components can be analyzed), high sensitivity (low LOQ values), and fast analysis (low retention times, especially for glutamate and GABA)

LC/MS Profiling and Gold Nanoparticle Formulation of Major Metabolites from Origanum majorana as Antibacterial and Antioxidant Potentialities

Origanum majoranum L. is a Lamiaceae medicinal plant with culinary and ethnomedical applications. Its biological and phytochemical profiles have been extensively researched. Accordingly, this study aimed to investigate the chemical composition and the antibacterial and antioxidant properties of O. majoranum high features, as well as to search for techniques for activity optimization. A metabolomics study of the crude extract of O. majoranum using liquid chromatography-high-resolution electrospray ionization mass spectrometry (LC ± HR ± ESI ± MS) was conducted. Five fractions (petroleum ether, dichloromethane, ethyl acetate, n-butanol, and aqueous) were derived from the total extract of the aerial parts. Different chromatographic methods and NMR analysis were utilized to purify and identify the isolated phenolics (high features). Moreover, the antimicrobial, antibiofilm, and antioxidant activity of phenolics were performed. Results showed that metabolomic profiling of the crude extract of O. majoranum aerial parts revealed the presence of a variety of phytochemicals, predominantly phenolics, resulting in the isolation and identification of seven high-feature compounds comprising two phenolic acids, rosmarinic and caffeic acids, one phenolic diterpene, 7-methoxyepirosmanol, in addition to four flavonoids, quercetin, hesperitin, hesperidin, and luteolin. On the other hand, 7-methoxyepirosmanol (OM1) displayed the most antimicrobial and antioxidant potential. Such a phenolic principal activity improvement seems to be established after loading on gold nanoparticles

Development of Azo Dye Immobilized Sulfonated Poly (Glycidyl Methacrylate) Polymer Composite as Novel Adsorbents for Water Treatment Applications: Methylene Blue Immobilization Isotherm, Kinetic, Thermodynamic, and Simulations Studies

Methylene blue (MB) immobilized onto a sulfonated poly(glycidyl methacrylate) (SPGMA) polymer composite has been developed as a novel adsorbent for water treatment applications. The MB adsorptions onto sulfonated poly(glycidyl methacrylate) polymer characters have been studied. The adsorption isotherms, namely Langmuir and Freundlich, have been investigated. Other isotherm models. As a compromise between the Freundlich and Langmuir isotherm models, such as the D–R isotherm and the Temkin isotherm, have been compared. The results indicated that the adsorption process followed the Freundlich isotherm model, indicating heterogeneous surface site energies and multi-layer levels of sorption. This study selected three linear kinetic models, namely pseudo-first order, pseudo-second order, and Elovich, to describe the MB sorption process using SPGMA negatively charged nanoparticles (430 nm). The obtained data revealed that the adsorption process obeyed the pseudo-second-order kinetic model, suggesting that the rate-limiting step in these sorption processes may be chemisorption. Furthermore, the thermodynamic parameters have been evaluated. Moreover, the interaction of the MB molecules with SPGMA nanoparticles has been simulated using the governing equation that describes ion exchange resin derived from Nernst—Plank equations between two ion species. Finally, the developed MB-SPGMA composite adsorbent (27 mg/g) wastested for the first time for the removal of Cr6+ ions and Mn7+ metal ions from dichromate and permanganate-contaminated waters under mild adsorption conditions, opening a new field of multiuse of the same adsorbent in the removal of more than one contaminant

Development of Azo Dye Immobilized Poly (Glycidyl Methacrylate-Co-Methyl Methacrylate) Polymers Composites as Novel Adsorbents for Water Treatment Applications: Methylene Blue-Polymers Composites

Methylene blue azo dye (MB) immobilized onto Poly (glycidyl methacrylate-Co-methyl methacrylate), (PGMA-co-PMMA), and sulphonated Poly (glycidyl methacrylate-Co-methyl methacrylate), (SPGMA-co-PMMA), polymers composites have been developed as novel adsorbents for water treatment applications. The effect of copolymer composition and sulphonation on the MB content has been studied. Maximum MB content was correlated to the Polyglycidyl methacrylate content for both native and sulphonated copolymers. Furthermore, the effect of the adsorption conditions on the MB content was studied. Sulfonated Poly (glycidyl methacrylate; SPGMA) was the most efficient formed composite with the highest MB content. The developed composites’ chemical structure and morphology were characterized using characterization tools such as particle size, FTIR, TGA, and SEM analyses. The developed MB-SPGMA composite adsorbent (27 mg/g), for the first time, was tested for the removal of Cr (VI) ions and Mn (VII) metal ions from dichromate and permanganate contaminated waters under mild adsorption conditions, opening a new field of multiuse of the same adsorbent in the removal of more than one contaminants

New Sulfamethoxazole Derivatives as Selective Carbonic Anhydrase IX and XII Inhibitors: Design, Synthesis, Cytotoxic Activity and Molecular Modeling

In this study new sulphamethoxazole derivatives (S1–S4, S6–S12, and S14–S22) were designed and synthesized and their structures were fully characterized and validated using NMR, mass, and IR spectroscopy, as well as elemental analyses. All new derivatives (S1–S22) were assayed against human carbonic anhydrase (hCAs IX and XII) for their inhibitory activities. hCAs IX and XII were chosen due to the fact that CAIX expression is recognized as a hypoxia marker with a poor prognosis in breast cancer. When compared to Dorzolamide HCl as a standard reference, derivatives S2, S3, S8, S9, and S15 had the most effective inhibition with low IC50 values. The active compounds were further evaluated against hCAs I and II inhibitory activity and compounds S8, S9 and S15 showed the least inhibitory effect compared to the reference standard, acetazolamide, indicating that their effect in normal cells is the lowest. Cell viability tests for the selected compounds were carried out on MCF7 (normoxia and hypoxia) and on the normal breast cell line (MCF10a) with Staurosporine as a standard. The results showed that compound S15 had a highly potent cytotoxic effect. Furthermore, cell cycle analysis results showed that compound S15 triggered cell cycle arrest and apoptosis in G1/S of MCF7 cancer cells. Finally, molecular docking was performed to point out the possible explanation for the vital structural features and key-interactions exerted by our ligands with hCAs IX and XII that might share additional designs and highlight possible leads for a hopeful anticancer agent. Consequently, sulphamethoxazole Derivative S15 could be the potential lead for emerging selective cytotoxic compounds directing h CAs IX and XII

Updated Treatment of Fibromyalgia Syndrome: A Review

Fibromyalgia is a debilitating condition that is frequently misdiagnosed. It affects 2% of the population, with middle-aged women having the highest frequency. Fibromyalgia affects more women than men, and It becomes worse as you get older. Because medical treatment for fibromyalgia is typically only partial, health professionals must provide patients with ongoing assistance in order for them to become effective, active self-managers. There is no one-size-fits-all drug for fibromyalgia, but you do have a lot of options for treating your symptoms. However, Antidepressants in general such as "duloxetine" and Gabapentinoids drugs such as "pregabline" are the most used drugs. There is some evidence that NSAIDs may have a synergistic effect when combined with centrally active agents such as tricyclic antidepressants and anticonvulsants. Among non-pharmacological therapy, exercise and psychoeducational techniques have the most evidence of efficacy, but they must be personalized to the individual. In this review we will be looking at diagnosis and treatment of fibromyalgia