Biopolymer Based Nanomaterials as Potential Biosorbents for Lead Ions

The objectives of the present work included synthesis of nanoparticles of calcium crosslinked alginate by emulsion crosslinking method and their characterization by techniques such as FTIR, TEM and XRD. In order to study the effect of various factors like adsorbent dose, initial metal ion concentration, pH and temperature on the removal of lead ions from water using nanoparticles of alginate, a series of batch sorption experiments were conducted. The obtained results were analyzed by Langmuir and Freundlich isotherm models and it was found that the adsorption of lead more precisely follows Freundlich adsorption isotherm. The results were also analyzed through various kinetic models like Lagergreen pseudo-first order kinetics, the pseudo-second order kinetics, and intraparticle diffusion model. Adsorption of Pb ions from aqueous solutions was found to be best described by pseudo second order Lagergreen equation. It was also found that intra particle transport was not the rate limiting step. The removal of Pb ions was found to be more than 90 percent. The metal ion removal capacity of the nanoparticles was found to depend on the chemical composition of the adsorbent, concentration of the metal ion solution, pH and temperature of the medium and speed of the suspension. Keywords: lead, alginate, nanoparticles, adsorption, emulsion cross linking

Solvent-free protocol for the green synthesis of benzamide analogs of dibenzoazepine

Dibenzoazepine represents an important class of heterocycles, exhibiting potent antidepressant and anticonvulsant activities. Beside, various modifications on this nucleus, amide analogs at N-5 position showed potent antidepressant activities. A previously reported method for the synthesis of benzamide analogs of dibenzoazepine use hazardous and toxic solvents. Herein, we report a new, efficient and solvent-free green method for the synthesis of dibenzoazepine benzamides (6-21)

Genotoksičnost nanočestica aluminijeva oksida, željeznog oksida i bakra u mišjim stanicama koštane srži

The aim of this study was to evaluate the genotoxic effects of Al2O3, Fe2O3, and Cu nanoparticles with chromosomal aberration (CA), micronucleus (MN), and comet assays on the bone marrow of male BALB/c mice. Three doses of Al2O3, Fe2O3 (75, 150, and 300 mg/kg), or Cu (5, 10, and 15 mg/kg) nanoparticles were administered to mice through intraperitoneal injection once a day for 14 days and compared with negative control (distilled water) and positive control (mitomycin C and methyl methanesulphonate). Al2O3 and Fe2O3 did not show genotoxic effects, but Cu nanoparticles induced significant (P<0.05) genotoxicity at the highest concentration compared to negative control. Our findings add to the health risk information of Al2O3, Fe2O3, and Cu nanoparticles regarding human exposure (occupational and/or through consumer products or medical treatment), and may provide regulatory reference for safe use of these nanoparticles. However, before they can be used safely and released into the environment further chronic in vivo studies are essential.Cilj ovog istraživanja bio je ocijeniti genotoksično djelovanje nanočestica Al2O3, Fe2O3 i Cu pomoću citogenetičkih testova kromosomskih aberacija, mikronukleus- i komet-testa u stanicama koštane srži muških BALB/c miševa. Miševi su intraperitonalnom injekcijom 14 dana primali jednu od triju doza Al2O3 ili Fe2O3 (75, 150 ili 300 mg/kg) odnosno Cu (5,10 ili 15 mg/kg) nanočestica jednom na dan, dok je negativna kontrolna skupina primala destiliranu vodu a pozitivna mitomicin C i metil-metansulfonat. Nanočestice Al2O3 i Fe2O3 nisu iskazale genotoksično djelovanje, ali je zato bakarpotaknuo značajnu (P<0,05) genotoksičnost u odnosu na negativnu kontrolu. Naši rezultati nadopunjuju spoznaje o rizicima za zdravlje povezanima s profesionalnom i drugom izloženosti (npr. putem potrošačke robe ili gdje se takve čestice primjenjuju u svrhu liječenja) nanočesticama Al2O3, Fe2O3 i Cu u ljudi te mogu poslužiti kao referenca pri utvrđivanju neškodljivih razina izloženosti u regulacijskim aktima. Potrebna su, međutim, daljnja istraživanja kronične toksičnosti ovih nanočestica in vivo kako bi se osigurala njihova sigurna primjena i spriječila štetna prisutnost u okolišu

Improving the decision-making process in the higher learning institutions via electronic records management system adoption

This is an accepted manuscript of an article published by KSII in KSII Transactions on Internet and Information Systems on 31/01/2021, available online: http://itiis.org/digital-library/24232 The accepted version of the publication may differ from the final published version.Electronic Records Management System (ERMS) is a computer program or set of applications that is utilized for keeping up to date records along with their storage. ERMS has been extensively utilized for enhancing the performance of academic institutions. The system assists in the planning and decision-making processes, which in turn enhances the competencies. However, although ERMS is significant in supporting the process of decision-making, the majority of organizations have failed to take an initiative to implement it, taking into account that are some implementing it without an appropriate framework, and thus resulted in the practice which does not meet the accepted standard. Therefore, this study identifies the factors influencing the adoption of ERMS among employees of HLI in Yemen and the role of such adoption in the decision-making process, using the Unified Theory of Acceptance and Use of Technology (UTAUT) along with Technology, Organization and Environment (TOE) as the underpinning theories. The study conducts a cross-sectional survey with a questionnaire as the technique for data collection, distributed to 364 participants in various Yemeni public Higher Learning Institutions (HLI). Using AMOS as a statistical method, the findings revealed there are significant and positive relationships between technology factors (effort expectancy, performance expectancy, IT infrastructure and security), organizational factors (top management support, financial support, training, and policy),environmental factors (competitiveness pressure, facilitating conditions and trust) and behavioral intention to adopt ERMS, which in return has a significant relationship with the process of decision-making in HLI. The study also presents a variety of theoretical and empirical contributions that enrich the body of knowledge in the field of technology adoption and the electronic record’s domain

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

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

Biopolymer Based Nanomaterials as Potential Biosorbents for Toxic Metal Ions

In the present work ternary nanoparticles of chitosan, yeast and gelatin were prepared by emulsion crosslinking method and characterized by techniques like FTIR and TEM. Whereas the spectral studies confirm the presence of characteristic functional groups of the three biopolymers. The TEM analysis also reveal that the size of nanoparticles lie in the range 50 to 150 nm. The nanospheres so prepared were examined for removal of Cu (II) ions and it was found that the removal capacity of metal ions was more than 90 percent. The metal ion removal capacity of the nanoparticles was found to depend on the chemical composition of the adsorbent, concentration of the metal ion solution, pH and temperature of the medium and agitation speed of the suspension