ENGINEERING ZINC OXIDE NANOPARTICLES TO BE USED AS NANOFERTILIZERS

Zinc deficient soils, or soils with low Zn bioavailability, are widespread, which exacerbates Zn deficiency in human as crops grown on these soils have low Zn content. Often crop yields are also compromised. Fertilizers based on soluble Zn salts often have limited efficacy in such soils. In this research, we evaluate the performance of polymer coated and bare ZnO nanoparticles (NPs) in an attempt to overcome limitations of soluble Zn salts in alkaline soils. We first synthesized 20-30 nm bare ZnO NPs with different surface chemistries to impart colloidal stability to the particles. Bare ZnO were treated in phosphate solution under certain conditions leading to the formation of a core made of ZnO NPs that is covered by a shell of amorphous Zn3(PO4)2 (core-shell NPs). This confers a negative charge to the particles over a wide pH range. The addition of nonionic (neutral dextran) and polyelectrolyte (negatively charged dextran sulfate (DEX(SO4)) during the synthesis resulted in the formation of DEX and DEX(SO4) ZnO NPs. Dextran has a minimal effect on the surface charge of ZnO but dextran sulfate confers a net negative charge. Bare and core-shell ZnO NPs were both electrostatically stabilized whereas DEX and DEX(SO4) ZnO NPs were sterically and electrosterically stabilized, respectively. We investigated the effect of treating seeds with ZnO NPs on the growth and accumulation of Zn in wheat (Triticum aestivum) seedlings in comparison to ZnSO4. All ZnO NPs stimulated seedling growth. Seedlings accumulated higher Zn concentrations when treated with ZnO NPs than with ZnSO4. Zinc sulfate was toxic even at the lower exposure concentrations, which was demonstrated by significantly lower germination success and seedling growth. In the second experiment, we investigated the effect of pH on the attachment and dissolution of ZnO NPs in soil, as compared to ZnSO4. Soil pH was adjusted to 6 and 8, then the soil was spiked with 100 mg Zn/kg soil in the form of ZnSO4, bare, DEX, DEX(SO4), and core-shell ZnO NPs. The results showed that DEX and core-shell ZnO NPs had significantly higher total Zn in soil solution compared to ZnSO4 at pH 8, with little dissolution. Dissolved Zn was similar among treatments except ZnSO4 at pH 6, indicating little dissolution of the ZnO NPs at either pH value. We also found that the engineered coatings dictate the behavior of the particles in simple aqueous systems, but their properties are altered in natural soil solutions because of the dominant effect of natural organic matter (NOM) on their surface chemistry. Based on the outcomes of the previous two experiments, we selected DEX and bare ZnO NPs to test the efficacy of ZnO NPs in delivering Zn to the grain of wheat under greenhouse conditions. We performed two independent studies where seeds were either treated with the NPs or grown in a soil spiked with Zn at pH 6 and 8 and spiked with Zn treatments (nano and ionic). We found that treating seeds with bare ZnO NPs significantly enhanced grain Zn concentrations as compared to the control, DEX-ZnO NPs, and ZnSO4. There were no differences in grain Zn concentration of plants treated with ionic or nano Zn treatments regardless of the soil pH. This work has elucidated important principles which will help carry forward efforts at developing effective ZnO NP-based fertilizers. It also suggests that treatment of seeds with ZnO NPs is more effective than amending soil or treating seeds with ZnSO4

Effect of Cucumber mosaic virus (CMV) on the Content of Some Cucumber Genotypes of Nitrogen, Protein, Phenols, and Flavonoids

This study was carried out to secreen the response of ten cucumber genotypes (AH-38، HA-37،HA-2160 ،HA2114 ، HA-2122 ،HA-12 ،HA-16 ،HA-41 ،CU-O719 , and CU-2102) against Cucumber mosaic virus (CMV) and to know the effect of infection on some of the plant contents of nitrogen, protein, phenols, and flavonoids. This study was carried out in the laboratory of Plant Virology and plastic houses of the College of Agriculture, University of Kerbala. The results showed that all cucumber genotypes tested in this study are susceptibe to CMV with severity infection ranged from 15-100%. It was also proved that the viral infection had a clear effect on reducing the content of the plant of nitrogen and protein in the genotypes and the most affected genotype was HA-2122 that was a significantly different from the content of nitrogen and protein in the non-infected plants. CMV was also found to have an effect in increasing the plant content of phenols and flavonoids in all genotypes infected with the virus (CMV) and the most affected genotypes were HA-37 and HA-41 (2.51 and 2.42 mg g-1 dry weight, respectively) and significantly different from the content of the same non-infected genotypes that gave rates of 1.66, 1.78 and 1.71 mg g-1 dry weight, respectively

LOW INCIDENCE AND MINIMAL IMPACT OF PARAVALVULAR LEAK AFTER CONVENTIONAL AORTIC VALVE REPLACEMENT.

OBJECTIVES: To evaluate the incidence of paravalvular leaks (PVLs) after surgical aortic valve replacement (AVR) and assess its impact on postoperative outcomes.METHODS: A retrospective review of 460 consecutive isolated AVR from January 2008 to December 2014. Postoperative transthoracic echocardiograms (TTE) and clinical notes were reviewed.RESULTS: Thirty-five patients (7.6%) developed a PVL and formed the cohort of this report. TTE grading of PVL was trivial in 18 (51.4%), mild in 14 (40%), moderate in 2 (5.7%) and severe in 1 patient (2.9%), with an overall prevalence of developing moderate to severe PVL after AVR of 0.065%. Mean age was 63 years, 23 patients were males (65.7%) and mean logistic Euroscore was 8.35 + 15.8%. Valve lesions were mainly stenosis (24 patients; 68.6%), regurgitation (7 patients; 20%) and mixed aortic lesions (4 patients; 11.4%). Implanted prostheses were 19 bioprosthesis  (54.2%) and 16 mechanical valves  (45.8%). We had one 30-days mortality (2.8%), 13 postoperative new onset atrial fibrillation (37%), permanent pacemaker 2.8%, cerebrovascular stroke 2.8%, re sternotomy for bleeding 2.8% and two patients needed hemodialysis (5.7%). Patients were followed up for 0.9 + 1.2 years. When last seen, 27 patients were in NYHA class I (77.1%), six patients were in class II (17.1%) and two patients with moderate to severe PVL remained in NYHA class IV (5.7%). Peak aortic valve gradients ranged from 14 to 68 mmHg, with a mean gradient of 27.8 + 13.3 mm Hg. Three patients with trivial PVL (8.5%) developed prosthetic valve endocarditis, with 2 patients among them requiring intervention for prosthetic valve failure (5.7%). Demographics, preoperative risk profiles and hospital outcomes were comparable to those recorded in the remaining 425 patients without PVL.CONCLUSION: The incidence of PVL after conventional AVR is small and the development of moderate or greater leaks is negligible. Trivial to mild leaks had a benign course unless complicated by PVE. New percutaneous therapies for aortic valve disease must match these low rates.Key words: Paravalvular leak, prosthetic valve dysfunction, aortic valve

European real world transcatheter aortic valve implantation: Systematic review and meta-analysis of European national registries

AbstractObjective: Transcatheter aortic valve implantation (TAVI) has been adopted rapidly in Europe despite the paucity of randomized studies. TAVI registries represent a real-world scenario thus providing the evidence for the treatment of high-risk patients. We undertook a meta-analysis of published European national TAVI registries to assess current results of TAVI technologies in Europe.Methods: Electronic databases were searched. The review focused on the comparison of the following TAVI technologies: transfemoral (TF) and transapical (TA) SAPIEN and CoreValve implantation. Individual event rates for outcomes of interest were pooled using a mixed effect model.Results: A total of 7 European national TAVI registries (UK, Swiss, Belgium, Italy, Spain, France, Germany) were identified including a total of 9786 patients who received TF SAPIEN  (n=2885), TA SAPIEN  (n=2252) and CoreValve (n=4649) implantation. Pooled incidence of 30 day mortality was 0.08 [95%Confidence Interval (CI): 0.05-0.11], 0.12 [95%CI: 0.07-0.19] and 0.06 [95%CI: 0.03-0.11] for TF SAPIEN, TA SAPIEN and CoreValve respectively (test for subgroup difference P=0.18) and high heterogeneity across European country was found. Pooled incidence of stroke was comparable among the TAVI technologies (test for subgroup difference P=0.79) as well as the incidence of postprocedural paravalvular leak ≥ 2 (P=0.9). CoreValve increased the risk of pacemaker implantation requirement (test for subgroup difference P<0.0001).Conclusions: Trans-vascular TAVI approaches were associated with a lower early mortality regardless of the type of device used. There was a marked heterogeneity among European countries for early mortality

Toxicogenomic responses of Caenorhabditis elegans to pristine and transformed zinc oxide nanoparticles

Manufactured nanoparticles (MNPs) undergo transformation immediately after they enter wastewater treatment streams and during their partitioning to sewage sludge, which is applied to agricultural soils in form of biosolids. We examined toxicogenomic responses of the model nematode Caenorhabditis elegans to pristine and transformed ZnO-MNPs (phosphatized pZnO- and sulfidized sZnO-MNPs). To account for the toxicity due to dissolved Zn, a ZnSO4 treatment was included. Transformation of ZnO-MNPs reduced their toxicity by nearly ten-fold, while there was almost no difference in the toxicity of pristine ZnO-MNPs and ZnSO4. This combined with the fact that far more dissolved Zn was released from ZnO- compared to pZnO- or sZnO-MNPs, suggests that dissolution of pristine ZnO-MNPs is one of the main drivers of their toxicity. Transcriptomic responses at the EC30 for reproduction resulted in a total of 1161 differentially expressed genes. Fifty percent of the genes differentially expressed in the ZnSO4 treatment, including the three metal responsive genes (mtl-1, mtl-2 and numr-1), were shared among all treatments, suggesting that responses to all forms of Zn could be partially attributed to dissolved Zn. However, the toxicity and transcriptomic responses in all MNP treatments cannot be fully explained by dissolved Zn. Two of the biological pathways identified, one essential for protein biosynthesis (Aminoacyl-tRNA biosynthesis) and another associated with detoxification (ABC transporters), were shared among pristine and one or both transformed ZnO-MNPs, but not ZnSO4. When comparing pristine and transformed ZnO-MNPs, 66% and 40% of genes were shared between ZnO-MNPs and sZnO-MNPs or pZnO-MNPs, respectively. This suggests greater similarity in transcriptomic responses between ZnO-MNPs and sZnO-MNPs, while toxicity mechanisms are more distinct for pZnO-MNPs, where 13 unique biological pathways were identified. Based on these pathways, the toxicity of pZnO-MNPs is likely to be associated with their adverse effect on digestion and metabolism

Age, Successive Waves, Immunization, and Mortality in Elderly COVID-19 Haematological Patients: EPICOVIDEHA Findings

Introduction: elderly patients with haematologic malignancies face the highest risk of severe COVID-19 outcomes. The infection impact in different age groups remains unstudied in detail. Methods: We analysed elderly patients (age groups: 65-70, 71-75, 76-80 and >80 years old) with hematologic malignancies included in the EPICOVIDEHA registry between January 2020 and July 2022. Univariable and multivariable Cox regression models were conducted to identify factors influencing death in COVID-19 patients with haematological malignancy. results: the study included data from 3,603 elderly patients (aged 65 or older) with haematological malignancy, with a majority being male (58.1%) and a significant proportion having comorbidities. The patients were divided into four age groups, and the analysis assessed COVID-19 outcomes, vaccination status, and other variables in relation to age and pandemic waves.tThe 90-day survival rate for patients with COVID-19 was 71.2%, with significant differences between groups. The pandemic waves had varying impacts, with the first wave affecting patients over 80 years old, the second being more severe in 65-70, and the third being the least severe in all age groups. factors contributing to 90-day mortality included age, comorbidities, lymphopenia, active malignancy, acute leukaemia, less than three vaccine doses, severe COVID-19, and using only corticosteroids as treatment. Conclusions: These data underscore the heterogeneity of elderly haematological patients, highlight the different impact of COVID waves and the pivotal importance of vaccination, and may help in planning future healthcare efforts

Integration of oncology and palliative care : a Lancet Oncology Commission

Full integration of oncology and palliative care relies on the specific knowledge and skills of two modes of care: the tumour-directed approach, the main focus of which is on treating the disease; and the host-directed approach, which focuses on the patient with the disease. This Commission addresses how to combine these two paradigms to achieve the best outcome of patient care. Randomised clinical trials on integration of oncology and palliative care point to health gains: improved survival and symptom control, less anxiety and depression, reduced use of futile chemotherapy at the end of life, improved family satisfaction and quality of life, and improved use of health-care resources. Early delivery of patient-directed care by specialist palliative care teams alongside tumour-directed treatment promotes patient-centred care. Systematic assessment and use of patient-reported outcomes and active patient involvement in the decisions about cancer care result in better symptom control, improved physical and mental health, and better use of health-care resources. The absence of international agreements on the content and standards of the organisation, education, and research of palliative care in oncology are major barriers to successful integration. Other barriers include the common misconception that palliative care is end-of-life care only, stigmatisation of death and dying, and insufficient infrastructure and funding. The absence of established priorities might also hinder integration more widely. This Commission proposes the use of standardised care pathways and multidisciplinary teams to promote integration of oncology and palliative care, and calls for changes at the system level to coordinate the activities of professionals, and for the development and implementation of new and improved education programmes, with the overall goal of improving patient care. Integration raises new research questions, all of which contribute to improved clinical care. When and how should palliative care be delivered? What is the optimal model for integrated care? What is the biological and clinical effect of living with advanced cancer for years after diagnosis? Successful integration must challenge the dualistic perspective of either the tumour or the host, and instead focus on a merged approach that places the patient's perspective at the centre. To succeed, integration must be anchored by management and policy makers at all levels of health care, followed by adequate resource allocation, a willingness to prioritise goals and needs, and sustained enthusiasm to help generate support for better integration. This integrated model must be reflected in international and national cancer plans, and be followed by developments of new care models, education and research programmes, all of which should be adapted to the specific cultural contexts within which they are situated. Patient-centred care should be an integrated part of oncology care independent of patient prognosis and treatment intention. To achieve this goal it must be based on changes in professional cultures and priorities in health care

Measures of MRI brain imaging biomarkers in middle age according to average Mediterranean diet score over the previous 25 years

The Mediterranean diet (MedDiet) has been linked with preservation of brain structures. Brain structural changes associated with cognitive impairment may occur during midlife, and timing of exposure may be critical. This study aims to examine the association of cumulative average MedDiet score from early through middle adulthood, and MedDiet scores at individual timepoints in relation to the midlife MRI brain measures. This study will also assess statistical mediation of brain measures on the association between cumulative average MedDiet score adherence and four cognitive domains: executive function, global cognition, processing speed, and verbal memory. 515 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study were included. Cumulative average MedDiet scores were calculated by averaging scores from baseline, year 7, and year 20 (mean age 25, 32, and 45, respectively). MRI brain scans were obtained at year 25 (mean age 50). General linear models adjusted for demographic variables, lifestyle factors, and vascular and metabolic comorbidities were used to examine all exposure-outcome relationships. Cumulative average MedDiet scores measured in tertiles were not associated with brain volumes. MedDiet scores examined separately at years 0, 7, and 20 were not associated with midlife brain measures. Higher cumulative average MedDiet scores were associated with better executive function (β= -0.38, ptrend <0.001). Brain volumes did not statistically mediate this association. This study’s findings suggest that diet characterized by MedDiet scores were not associated with midlife brain volumes. Midlife brain volumes did not statistically mediate the association between the MedDiet and cognition

Dietary and lifestyle habits among university students at different academic years

Background/aimsCollege serves as a transitionary period into adulthood where students begin making independent dietary and lifestyle choices and begin forming possibly detrimental habits. Such habits may persist into adulthood and negatively affect their long-term health and risk of disease. This study aimed at exploring the dietary and lifestyle habits among the Hashemite University students at different academic years. MethodsA cross-sectional design was used to study dietary and lifestyle habits as well as the occurrence of obesity among a convenient sample of undergraduate students at the Hashemite University during the academic year 2015–2016. Five hundred and forty students (184 males: 356 females) were enrolled in this study. Bodyweight and height were measured and body mass index was calculated. Personal information, dietary habits and physical activity data were collected using constructed questionnaires. ResultsAround 36% of the students were overweight and obese. The percentage of overweight among the freshmen was about 31% and 26.5% among the seniors. Additionally, 8.6% of freshmen and 16.3% of seniors were found to be obese. One-third (30.2%) of the study sample was hookah smokers, while 15.4% were cigarette smokers. The students showed similar physical activity levels in the four academic years. The majority of students at different academic levels consumed fruits 1–2 times/week and 5 times cereals, grains, and starchy vegetables/day. ConclusionOur results show that approximately one-third of students are overweight or obese, and practicing unhealthy dietary and lifestyle habits. This indicates a need to address this problem, possibly through implementing a nutrition and health education programs at the university in addition to improving the quality of food available on campus

Which beta-blocker should be used for the prevention of postoperative atrial fibrillation in cardiac surgery? A multi-treat

Background: Post-operative atrial fibrillation (POAF) is amongst the most common complications following cardiac surgery. Current guidelines recommend oral beta-blockers as a first-line medication to prevent POAF. However, the ideal choice of beta-blocker is unclear, making a comprehensive review crucial. We aimed to provide a clinically useful summary of the results of a multiple-treatment meta-analysis of randomized controlled trials (RCT). Methods and Results: A MEDLINE/PubMed search was conducted to identify eligible RCTs. Efficacy (POAF prevention rate) and acceptability (dropout for side effect rate) outcomes were investigated. A frequentist approach to network meta-analysis using the graph-theoretical method was implemented to obtain network estimates. A total of 16 trials were included in the final analysis and 4727 subjects were investigated. Network estimates showed that betaxolol (OR 0.36; 95%CI 0.25–0.52), carvedilol (OR 0.36; 95%CI 0.23–0.58) and sotalol (OR 0.38; 95%CI 0.30–0.50) were more effective than propranolol (OR 0.51; 95%CI 0.27–0.95), metoprolol (OR 0.72; 95%CI 0.58–0.90) and atenolol (OR 0.81; 95%CI 0.42–1.56) in reducing the incidence of POAF when compared to placebo. Amongst beta-blockers investigated, carvedilol showed the best safety profile being associated with the lowest risk of patient dropped out for side effect (OR 1.14; 955CI 0.36–3.61). No evidence of heterogeneity/inconsistency was found in the whole network for both efficacy (P = 0.8) and acceptability (P = 0.4) outcomes. Conclusion: Overall, carvedilol was found to be effective in preventing POAF while maintaining a good safety profile