Outcomes of Multiple Myeloma in Hospitalized Patients With Opioid Use Disorder: A Nationwide Analysis

Multiple myeloma is commonly associated with advanced age. This study aims to investigate how multiple myeloma outcomes are affected by opioid use disorder (OUD) among hospitalized patients. We analyzed the National Inpatient Sample (NIS) for 2019 and 2020 for our retrospective cohort study. International Classification of Diseases Clinical Modification codes (ICD-10-CM) were utilized to identify the population of interest. Primary and secondary outcomes were studied using a multivariate regression model. Among the 38,735 patients hospitalized with multiple myeloma, 350 patients had the concurrent diagnosis of opioid use disorder. OUD patients were found to be at increased risk for major depressive disorder aOR[1] 2.57 (95% CI 1.39–4.755), p = 0.003; delirium aOR 3.48 (95% CI 1.066–11.38); p = 0.04; insomnia aOR 2.77 (95% CI 1.31–5.87); p= 0.008; and hypercalcemia aOR 2.71 (95% CI 1.31–5.63) p= 0.007. Total hospitalization charges decreased in patients with OUD, and no significant difference between the two groups in the length of hospital stay or mortality was noted. Among patients admitted with OUD, the rates of delirium, major depressive disorder, insomnia, and hypercalcemia were higher than those without any OUD without any significant difference in mortality. [1]aOR: Adjusted Odds Rati

Glassy Powder Derived from Waste Printed Circuit Boards for Methylene Blue Adsorption

Electronic waste (e-waste) is one of the fastest-growing waste streams in the world and Europe is classified as the first producer in terms of per capita amount. To reduce the environmental impact of e-waste, it is important to recycle it. This work shows the possibility of reusing glassy substrates, derived from the MW-assisted acidic leaching of Waste Printed Circuit Boards (WPCBs), as an adsorbent material. The results revealed an excellent adsorption capability against methylene blue (MB; aqueous solutions in the concentration range 10−5 M–2 × 10−5 M, at pH = 7.5). Comparisons were performed with reference samples such as activated carbons (ACs), the adsorbent mostly used at the industrial level; untreated PCB samples; and ground glass slides. The obtained results show that MW-treated WPCB powder outperformed both ground glass and ground untreated PCBs in MB adsorption, almost matching AC adsorption. The use of this new adsorbent obtained through the valorization of e-waste offers advantages not only in terms of cost but also in terms of environmental sustainability

Incidence of Depression and Anxiety among Patients with Acute Myocardial Infarction during COVID-19 Pandemic

Objective:  This study aimed to assess the incidence of anxiety and depression among AMI patients during COVID-19 pandemic in Pakistan. Material & Method:  This cross-sectional study was conducted from February 27 to June 2, 2020, at the Cardiology ward of Dera Ghazi Khan Teaching Hospital.  Total 611 patients selected through convenience sampling. The patients were requested to respond to Hospital Anxiety and Depression Scale (HADS) and demographic information. An independent samples t test was applied for comparisons. Results:  Patients’ age was ranging from 41 to 79 years, with a mean age of 52.35 ± 5.12. There was a high frequency of anxiety (51.72%) and depression (34.86%) among AMI patients. A significant difference was observed in the level of anxiety (p = 0.001) and depression (p = 0.000) among male and female patients. Conclusion:  The present study findings affirmed that increased level of anxiety and depression are prevalent in AMI patients. Additionally, both anxiety and depressive symptoms were more common in female patients. Keywords:  COVID-19, Anxiety, Depression, Acute Myocardial Infarction (AMI)

Perovskite Solar Cells: Potentials, Challenges, and Opportunities

Heralded as a major scientific breakthrough of 2013, organic/inorganic lead halide perovskite solar cells have ushered in a new era of renewed efforts at increasing the efficiency and lowering the cost of solar energy. As a potential game changer in the mix of technologies for alternate energy, it has emerged from a modest beginning in 2012 to efficiencies being claimed at 20.1% in a span of just two years. This remarkable progress, encouraging at one end, also points to the possibility that the potential may still be far from being fully realized. With greater insight into the photophysics involved and optimization of materials and methods, this technology stands to match or even exceed the efficiencies for single crystal silicon solar cells. With thin film solution processability, applicability to flexible substrates, and being free of liquid electrolyte, this technology combines the benefits of Dye Sensitized Solar Cells (DSSCs), Organic Photovoltaics (OPVs), and thin film solar cells. In this review we present a brief historic perspective to this development, take a cognizance of the current state of the art, and highlight challenges and the opportunities

Synergic effect of sulfur and nitrogen on morpho-physiological and biochemical traits of sunflower

Macronutrients are essential for plant growth and development because they give plants the building blocks, they need to stay healthy and do important biological processes. A completely randomized designed (CRD) pot experiment was done to find out how nitrogen and sulfur affected the morphology and biochemistry of sunflowers. There were three replicates of each treatment: N1 (0), N2 20 kg ha-1 and N3 40 kg ha-1 and sulfur S1 (0), S2 40 kg ha-1 and S3 60 kg ha-1. Sunflower growth and physiology were improved by exogenously applied sulfur and nitrogen to the plant. Root and shoot length, fresh and dry weight, number of leaves per plant, leaf area, plant height, chlorophyll a, chlorophyll b, carotenoids, total soluble protein, and shoot calcium, potassium, and sodium ions contents all went up compared to the control conditions. Furthermore, sulfur and nitrogen have positive impacts on sunflowers' growth, ionic parameters and there was increase for anthocyanin (24.98%. and 36.66%), ascorbic acid (43.17% and 97.88%), and flavonoid (34.56%. and 112.91%) amounts with the highest levels at 60 kg ha-1 of S and 40 kg ha-1 of N, respectively. There was significant increase in photosynthetic pigments on application of Sulphur (Chl a. :19.15%, Chl b.  52.17%) and Nitrogen (chla. 20.53%, Chl b. 57.16%). Thus, applying sulfur and nitrogen externally to the plant is suggested to boost sunflower growth and chlorophyll levels at different nutritional levels

Awareness, use and perceptions about E-cigarettes among adult smokers in Karachi, Pakistan.

OBJECTIVE: To estimate the prevalence of awareness, current use and intention to use of e-cigarettes among adult smokers. METHODS: This cross-sectional survey was carried out at the Aga Khan University Hospital, Karachi, from July to August 2016, and comprised people aged above 18 years who had smoked more than 100 cigarettes in their lifetime. Convenience sampling method was used. A self-administered questionnaire was used to collect data. SPSS 22 was used for data analysis.. RESULTS: Of the 387 participants, 359(92.8%) were male. The overall mean age was 32.4±12.6 years. Moreover, 215(55.5%) respondents belonged to the middle socio-economic class. Besides, 249(64.3%) respondents were aware of e-cigarettes while 39(10.1%) used them, and 81(20.9%) wanted to use them. Socio-economic status was the best predictor for awareness about e-cigarettes (p CONCLUSIONS: The percentage of e-cigarette usage was low despite the higher than expected awareness among the subjects

Experimental investigation to thermal performance of different photo voltaic modules for efficient system design

Due to rapid industrialization, and depletion of fossil fuels, alternative renewable resources are mandatory, where solar thermal energy is one of the promising alternate. In this study, an experimental investigation was conducted to analyze the thermal performance of different photovoltaic-modules under varying climate conditions. These include thin plate Copper indium diselenide, mono-crystalline silicon, micro crystalline silicone, amorphous silicon and poly-crystalline silicon. The analysis was concentrated on the evaluation of module efficiency, solar irradiance absorption rate, maximum power output, performance ratio, normalized power output efficiency and temperature effect on each module at real operational outdoor conditions. Mono-crystalline silicon module showed high average efficiency of 20.8% and average performance ratio 1.21 compared to the other PV modules. It was observed that all types of modules have higher average temperature in summer season and showed low performance ratio and low module efficiency as compared to winter season. Average normalized power out of mono-crystalline silicon 56.2% more efficient than the other modules. The increased thermal performance of mono-crystalline silicon was related with its high absorption rate and high conduction rate. Thus, mono-crystalline silicon PV module is the best potential candidate for solar capturing technique to be utilize in diverse solar thermal energy applications

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication