Propofol and Kearns-Sayre Syndrome: An idiographic approach

With the focus on an idiographic approach whereby the observations incorporated the various dimensions of individual functioning ‘top-down’ to ‘bottom-up’, this case report describes the successful management of a 14-year-old girl with Kearns-Sayre syndrome and Dyggve-Melchior-Clausen disease requiring a transvenous permanent pacemaker implantation for complete heart block. The patient presented to a tertiary care centre in Muscat, Oman, in 2023 seeking consultation. The current idiographic approach appears to have a heuristic value for 2 interrelated reasons. Firstly, it is unlikely that even tertiary care units can accrue such rare presentations and scrutinise them under nomothetic approach. Secondly, by employing the idiographic approach that is capable of examining each case in-depth, the aspiration for good health and well-being may come to the forefront. To the best of the authors’ knowledge this is the first published idiographic report in anaesthesia care. Keywords: Intravenous Anaesthetics; Artificial Pacemaker; Kearns-Sayre Syndrome; Propofol; Idiographic Approach; Case Report; Oman

Titanium dioxide-modified polyetherimide nanofiber membrane for water treatment

The main objective of this work is to fabricate and characterize a new type of nanocomposite nanofiber membrane by incorporating photocatalytic nanomaterials – titanium dioxide (TiO2) into a highly porous nanofiber made of UV-resistant polyetherimide (PEI). The nanofiber membrane was fabricated via an electrospinning method using a dope solution containing 15 wt% PEI dissolved in a mixed solvent of dimethylformamide (DMF)/n-methyl-2-pyrrolidone (NMP). The resultant PEI nanofiber membrane was further modified by coating its surface with TiO2 (0.2 and 0.6 wt%) using electrospraying method. The properties of the TiO2-modified PEI nanofiber membranes were then analysed using scanning electron microscope (SEM), water contact angle (WCA) goniometer and tensile strength machine. Results showed that 0.2 wt% TiO2-modified PEI nanofiber displayed better behaviour by reducing WCA of unmodified nanofiber from 130.25° to 23.35° and improving water flux by 28%. Although the WCA of membrane was further reduced when a higher TiO2 amount (0.6 wt%) was used, the resultant nanofiber suffered from decreased ultimate strength and significant nanoparticles leaching. Using the best performing 0.2% TiO2-modified PEI membrane, significant removal rate of Escherichia coli (99%) and humic acid (∼80%) could be achieved along with 85% methylene blue degradation during photocatalytic process. The findings of this work provide an insight into the design of advanced nanocomposite nanofiber membrane for photocatalytic process

Awareness of Child Rights Laws among School Principals in Oman and its Impact on their Daily Practices

The study aimed to investigate the degree of awareness of school principals in Oman about the International Convention on the Rights of the Child and the Omani Children\u27s Law and to determine the impact of this awareness on their daily practices towards children. The population of the study consisted of school principals and assistant principals in five provinces: Muscat, Addakhiliyah, Albatinah, Musandam, and Zafar; where child-friendly school’s initiative was launched as part of the collaboration between the Ministry of Education and the UNESCO Office in Oman. The sample of the study consisted of principals and assistant principals in 48 schools in these five provinces. The results of the study showed that the awareness of the child rights laws had a positive impact on the practices of school principals in general and on the legal, cultural, and political rights of children in particular. The results also indicated a statistically significant difference according to gender in favor of females; while there was no effect based on the type of school. The study endorsed the importance of activating the child-friendly school’s initiative and the necessity of developing the tasks of school principals in the light of child rights laws. Keywords: Child’s rights laws, school principals, child friendly school

Iron oxide nanoparticles incorporated polyethersulfone electrospun nanofibrous membranes for effective oil removal

This paper reports the synthesis and characterization of novel ultrafiltration (UF) electrospun nanofibrous membranes (ENMs) incorporated with iron oxide (Fe3O4) nanoparticles (NPs) for effective oily solution treatment. Three strategies were employed to improve the physiochemical properties of the resultant ENMs. Firstly, n-methyl-pyrrolidinone (NMP) was added to dimethylformamide (DMF) wherein the solvent stimulated fusion of the inter-fiber junctions was enhanced. Secondly, Fe3O4 NPs were introduced into the ENMs to improve their hydrophilicity and anti-fouling resistance against oil molecules. Thirdly, hot pressed technique was adopted to strengthen the electrospun mat, avoiding delamination of the ENMs layer during liquid filtration processes. The findings indicated that the developed Fe3O4 NPs incorporated ENMs exhibited outstanding oil elimination (94.01%) and excellent water flux recovery (79.50%) when tested with synthetic oil solution (12,000 ppm). Water productivity of over 3200 L/m2 h was achieved without forfeiting the rate of oil removal under gravity. Extraordinarily low flux declination disclosed by the proposed ENMs was attributed to their tailored surface resistance mediated oil anti-fouling character. The enhanced mechanical and oil anti-fouling traits of the prepared ENMs were established to be potential for the treatment of diverse oily effluents (especially emulsions of oil–water) in the industries

Fabrication of polyethersulfone electrospun nanofibrous membranes incorporated with hydrous manganese dioxide for enhanced ultrafiltration of oily solution

In this work, a new type of ultrafiltration (UF) electrospun nanofibrous membranes (ENMs) incorporating hydrous manganese dioxide (HMO) nanoparticles was fabricated with the objective of improving properties of polyethersulfone (PES)-based membrane for synthetic oily solution treatment. Two treatments were carried out to improve the mechanical property and hydrophilicity of the PES-based membrane without compromising its porosity and water permeance. The first treatment involved the use of mixed solvents – dimethylformamide and n-methyl-pyrrolidinone (DMF/NMP) in which NMP is a high vapor pressure component that could enhance the mechanical properties of the nanofibrous by improving solvent-induced fusion of inter-fiber junction points. The second treatment involved the incorporation of specific amount of HMO nanoparticles in PES dope solution to enhance membrane hydrophilicity. Heat treatment was also adopted as an effective approach to strengthen and prevent delamination of the nanofibrous mat during UF process. The HMO-incorporated ENMs exhibited an excellent oil rejection (97.98% and 94.04%) and a promising water flux recovery (89.29% and 71.10%) when used to treat a synthetic oily solution containing 5000 or 10,000 ppm oil, respectively. The best promising HMO-incorporated ENM exhibited much higher magnitude of water productivity (>7000 L/m2h) without sacrificing oil removal rate. Most importantly, this nanofillers-incorporated membrane showed significantly lower degree of flux decline as a result of improved surface resistance against oil fouling and is of potential for long-term operation with extended lifespan. The promising mechanical and anti-fouling properties of the ENMs is potentially applicable in the efficient industrial oily effluents treatment when challenged with oil-in-water emulsions

Implementation of the INTERGROWTH-21st Project in Oman.

The Middle Eastern site in the INTERGROWTH-21(st) Project was Muscat, the capital city of Oman, with approximately 10,500 births per year. The sample for the Newborn Cross-Sectional Study (NCSS) was drawn from two hospitals covering 96% of the region's births. The Fetal Growth Longitudinal Study (FGLS) sample was recruited from four primary health facilities serving Khoula Hospital, using the eligibility criteria in the INTERGROWTH-21(st) protocol. Special activities to encourage participation in this population included local advocacy campaigns to encourage early antenatal booking and ultrasound dating in the population. The major challenges at the site were the recruitment of sufficient numbers of women at an early gestational age, and the timely measurement of all newborns within 12 hours of birth. Many individuals and institutions collaborated effectively over a period of several years on these studies, which required careful planning and close monitoring for their successful implementation

The gulf implantable cardioverter-defibrillator registry: Rationale, methodology, and implementation

Background: The implantable cardioverter-defibrillator (ICD) is effective in the prevention of sudden cardiac death in high-risk patients. Little is known about ICD use in the Arabian Gulf. We designed a study to describe the characteristics and outcomes of patients receiving ICDs in the Arab Gulf region. Methods: Gulf ICD is a prospective, multi-center, multinational, and observational study. All adult patients 18 years or older, receiving a de novo ICD implant and willing to sign a consent form will be eligible. Data on baseline characteristics, ICD indication, procedure and programing, in-hospital, and 1-year outcomes will be collected. Target enrollment is 1500 patients, which will provide adequate precision across a wide range of expected event rates. Results: Fifteen centers in six countries are enrolling patients (Saudi Arabia, United Arab Emirates, Kuwait, Oman, Bahrain, and Qatar). Two-thirds of the centers have dedicated electrophysiology laboratories, and in almost all centers ICDs are implanted exclusively by electrophysiologists. Nearly three-quarters of the centers reported annual ICD implant volumes of ≤150 devices, and pulse generator replacements constitute <30% of implants in the majority of centers. Enrollment started in December 2013, and accrual rate increased as more centers entered the study reaching an average of 98 patients per month. Conclusions: Gulf ICD is the first prospective, observational, multi-center, and multinational study of the characteristics and, the outcomes of patients receiving ICDs in the Arab Gulf region. The study will provide valuable insights into the utilization of and outcomes related to ICD therapy in the Gulf region

Achieving accurate estimates of fetal gestational age and personalised predictions of fetal growth based on data from an international prospective cohort study: a population-based machine learning study

Background Preterm birth is a major global health challenge, the leading cause of death in children under 5 years of age, and a key measure of a population’s general health and nutritional status. Current clinical methods of estimating fetal gestational age are often inaccurate. For example, between 20 and 30 weeks of gestation, the width of the 95% prediction interval around the actual gestational age is estimated to be 18–36 days, even when the best ultrasound estimates are used. The aims of this study are to improve estimates of fetal gestational age and provide personalised predictions of future growth. Methods Using ultrasound-derived, fetal biometric data, we developed a machine learning approach to accurately estimate gestational age. The accuracy of the method is determined by reference to exactly known facts pertaining to each fetus—specifically, intervals between ultrasound visits—rather than the date of the mother’s last menstrual period. The data stem from a sample of healthy, well-nourished participants in a large, multicentre, population-based study, the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st). The generalisability of the algorithm is shown with data from a different and more heterogeneous population (INTERBIO21st Fetal Study). Findings In the context of two large datasets, we estimated gestational age between 20 and 30 weeks of gestation with 95% confidence to within 3 days, using measurements made in a 10-week window spanning the second and third trimesters. Fetal gestational age can thus be estimated in the 20–30 weeks gestational age window with a prediction interval 3–5 times better than with any previous algorithm. This will enable improved management of individual pregnancies. 6-week forecasts of the growth trajectory for a given fetus are accurate to within 7 days. This will help identify at-risk fetuses more accurately than currently possible. At population level, the higher accuracy is expected to improve fetal growth charts and population health assessments. Interpretation Machine learning can circumvent long-standing limitations in determining fetal gestational age and future growth trajectory, without recourse to often inaccurately known information, such as the date of the mother’s last menstrual period. Using this algorithm in clinical practice could facilitate the management of individual pregnancies and improve population-level health. Upon publication of this study, the algorithm for gestational age estimates will be provided for research purposes free of charge via a web portal