Room temperature bio-engineered multifunctional carbonates for CO2 sequestration and valorization

This contribution reports, for the first time, on an entirely green bio-engineering approach for the biosynthesis of single phase crystalline 1-D nano-scaled calcite CaCO3. This was validated using H2O as the universal solvent and natural extract of Hyphaene thebaica fruit as an effective chelating agent. In this room temperature green process, CaCl2 and CO2 are used as the unique source of Ca and CO3 respectively in view of forming nano-scaled CaCO3 with a significant shape anisotropy and an elevated surface to volume ratio. In terms of novelty, and relatively to the reported scientific and patented literature in relation to the fabrication of CaCO3 by green nano-chemistry, the current cost effective room temperature green process can be singled out as per the following specificities: only water as universal solvent is used, No additional base or acid chemicals for pH control, No additional catalyst, No critical or supercritical CO2 usage conditions, Only natural extract of thebaica as a green effective chelating agent through its phytochemicals and proper enzematic compounds, room Temperature processing, atmospheric pressure processing, Nanoscaled size particles, and Nanoparticles with a significant shape anisotropy (1-D like nanoparticles). Beyond and in addition to the validation of the 1-D synthesis aspect, the bio-engineered CaCO3 exhibited a wide-ranging functionalities in terms of highly reflecting pigment, an effective nanofertilizer as well as a potential binder in cement industry.

Candida pneumonia in young and immunocompetent lady: A case report and literature review

Background

Candida is a frequent respiratory tract colonizer. True candida pneumonia is rare and seen with predominance in immunosuppressed patients. Our aim is to document a previously unreported case of Candida pneumonia in a young and immunocompetent patient, highlighting, an unusual pathological manifestation of this infection in immunocompetent individuals.

Case summary

We report a previously healthy young lady who remained symptomatic with fever, cough and shortness of breath for three weeks duration despite treatment with extensive antibiotics regimen for community acquired pneumonia. She was eventually treated as a probable, rare case of candida pneumonia. The patient demonstrated a dramatic response to single antifungal treatment both clinically and biochemically within the first 24hrs of treatment. Candida albican was isolated on repetitive cultures form the sputum and bronchoalevolar lavage samples. The patient had negative blood cultures. Her HRCT scan revealed bilateral basal air space opacities with peri bronchovascular distribution and centrilobular nodules with branching pattern suggestive of tree in bud predominantly in lower lobes. Her endobronchial biopsies was mostly unremarkable apart from rare non-necrotizing granuloma.

Conclusion

Candida can rarely cause clinically significant pneumonia in immunocompetent patients and should be considered in the differential diagnosis of granulomatous lung disease.

Characterization and antibacterial activity of raw cotton fabrics treated with date seed extract and silver nanoparticles (AgNPs)

Because of their immense economic, wellness, and remedial value, the seeds of palm (Phoenix dactylifera) were selected with synthesized silver nanoparticles (AgNPs) based on their properties for increasing the antibacterial efficacy of medical cotton. This study aimed to be contingent upon the characterisation of raw cotton fabrics treated by AgNPs with date seed extract (DSE) of P. dactylifera both individually and in combination and to investigate their antibacterial activity against various human pathogens. The prepared cotton materials with the synthesized AgNPs and/or DSE were described by both X-ray diffraction (XRD) and scanning electron microscope (SEM). At the same time, gas chromatography-mass spectrometry (GC-MS) and High-performance liquid chromatography (HPLC) were employed to determine the bioactive components in the aqueous date seed extract. The greater antibacterial activity was recorded by cotton treated with DSE and AgNPs mix, in which inhibition zones of all treatments were against Escherichia coli (8 cm), followed by Staphylococcus aureus (2.33-5.87cm) and Bacillus subtilis (2.17-4.63 cm), respectively. Overall, these findings indicate that treated cotton fabrics with synthesised AgNPs and DSE may be widely applied in various potential biological and medical applications, which could enhance environmental sustainability in closed production and consumption.

A LONG-TERM 10G-HYPERGRAVITY EXPOSURE PROMOTES CELL-CELL CONTACTS AND REDUCES ADHESIVENESS TO A SUBSTRATE, MIGRATION, AND INVASIVENESS OF MCF-7HUMAN BREAST CANCER CELLS

BACKGROUND

G-force is a fundamental force controlling human cells. Cancer is one of the 4 major health challenges in the Space missions. Cancer in Space project evaluates the reaction of human cancer cells to the conditions of the space flights, including an exposure to high g-forces.

AIM

Explore an impact of 10 g force on the oncogenic properties of human breast adenocarcinoma cells MCF-7.

MATERIALS AND METHODS

Cells were exposed to 10 g force for 10 days, as part of a 6-week simulation of conditions of a space flight. Then the cells were cultured for one week under normal culture conditions, before performing tests. Cell proliferation, cell viability, cell-cell contact inhibition, migration, and invasiveness were measured. Immunoblotting was used to evaluate expression of proteins.

RESULTS

Proliferation, cell-cell interaction and formation of 3D structures, migration, and invasiveness of cells exposed to 10 g were compared to parental cells cultured at 1 g condition. 10 g exposed cells showed a higher propensity for cell-cell contact inhibitions and lower for 3-dimensional growth in dense culture. This correlated with the decrease of proliferation in a dense culture as compared to the parental cells. The decrease of migration, adherence to a surface, and invasiveness was observed for cells subjected to the hypergravity, as compared to the parental MCF-7 cells. Enhanced expression of E-cadherin and phosphorylated pY576-FAK were observed in 10 g exposed cells but no impact on the expression of Erk, pErk, FAK and p53 was detected.

CONCLUSION

The prolonged exposure of MCF-7 cells to 10 g force targets cell-cell and cell-substrate interactions.

Identifying and validating game design elements in serious game guideline for climate change

Climate change can simply be defined as an increase in temperature, normally referred to as global warming. Recent studies have confirmed the failure of many climate communication efforts due to the one-directional transmission of information that has transformed the audience into passive consumers of information. The young generation tends to be avid gamers, thus serious games could be a suitable medium to increase climate change awareness in order to cultivate a better attitude towards nature among this group. However, very few games focus on carbon cycle fundamentals that are directly related to climate change. Existing climate change games have been unable to improve the quality of knowledge on environmental issues due to the lack of contextualization of the carbon cycle. Thus, the purpose of this study was to develop and verify a guideline of game design elements to assist game developers in developing a climate change game that can facilitate experiential learning on climate change based on the carbon cycle. The guideline consists of 13 game elements derived from previous studies. Seven experts from both game and environmental areas were selected to review the designed guideline. The experts were given two to six weeks to evaluate the guideline and were asked to rate and comment on each game element. At the end of the review, the experts' feedback and comments were analysed and scrutinised. The results showed positive feedback from all experts. The guideline was updated based on the experts’ comments, and finally a total of 12 game elements for a climate change game remained. This guideline can be applied to develop a new climate change game. This paper discusses the validation of the guideline proposed for a climate change game design.

Proficiency-based progression training: implementing a novel approach to training for epidural analgesia in labour

BACKGROUND

Epidural insertion is a challenging anaesthetic procedural skill to learn and may require up to 75 attempts to achieve competency. Proficiency-based progression (PbP) training based on unambiguously defined metrics was associated with a 53% reduction in epidural failure rate. The aim of this observational study was to examine the feasibility of implementation of innovative PbP training for labour epidural insertion performed by novices in a busy tertiary hospital.

METHODS

All trainees who were scheduled to commence their obstetric anaesthesia training were invited to participate. Novices undertook intensive PbP training with one-to-one supervision by an anaesthetist trained in PbP. Trainees proceeded to the clinical phase only after attaining the pre-defined proficiency benchmark. All subsequent attempts at labour epidural catheter placement were evaluated.

RESULTS

All 12 novice trainees who were scheduled for their initial exposure to obstetric anaesthesia completed PbP training in epidural catheter insertion successfully. The average duration of the training courses was 70 (SD 11) min. Trainee characteristics were broadly similar. They performed a total of 180 labour epidural catheter placements with an overall epidural failure rate of 12.2% (22/180). The proportion of supervisor takeover was 6% (11/179). The incidence of complications was 4% (8/180) and difficulty in epidural catheter insertion due to patient factors was 16% (29/180). Patient satisfaction rates were 80% (satisfied or very satisfied), with 20% unsatisfied with their experience of epidural insertion.

CONCLUSION

In our experience, PbP training in epidural placement is feasible within existing departmental resources in a busy tertiary teaching hospital setting.

Role of Left Ventricular Speckle Tracking Imaging in Detection of Coronary Artery Disease in Non-Diabetic Patients

This study aimed to determine the role of global longitudinalstrain (GLS) in early diagnosis and detection of severity of coronaryartery disease (CAD) in non-diabetic patients with preservedleft ventricular ejection fraction (EF) without regionalwall motion abnormalities presented with chronic coronary syndrome,and to identify the role of territorial longitudinal strain(TLS) in detection of the affected coronary artery. We enrolled60 non-diabetic patients with suspected CAD who underwentresting echocardiography and speckle tracking imaging andsubsequently coronary angiography then results were correlatedtogether. Patients with family history of CAD (68.3%), hypertension(68.3%), smokers (43.3%), and dyslipidemia (81.6%). Allparticipants had normal left ventricular systolic function withmean EF of 64.02±6.15% and no regional wall motion abnormalitiesat rest. Patients were classified angiographically accordingto the number of the diseased vessels into: 3 vessels disease(43.3%), 1-2 vessels disease (35%), and normal coronaryangiography (21.7%) with GLS mean values of -13.69±1.94%,-15.4±1.74%, and -18.80±2.14%, respectively. There was a negativesignificant correlation between GLS values and the numberof diseased vessels (P=0.001). The values of TLS were significantlylower in myocardial regions supplied by stenotic arteries thanthose supplied by non-stenotic arteries. Mean TLS values forstenotic left anterior descending, left circumflex, and right coronaryarteries were -15.51±3.19, -13.06±2.90, -13.27±2.60 withP=0.011, 0.001, and 0.001, respectively. Speckle tracking derivedGLS is an effective non-invasive method in predicting presenceand severity of CAD and in locating the affected vessels basedon the distribution of segments affected in TLS.

The determinant factors for the adoption of CRM in the Palestinian SMEs: The moderating effect of firm size

CRM adoption can provide innumerable benefits to the SMEs performance, including solving customer problems in a timely manner, enhancing customer satisfaction by appointing an expert to solve issues and queries, and the like. This study aims to examine the moderating effects of the firm size in the adoption of CRM in the Palestinian SMEs. A quantitative approach was used to investigate the relationships between the variables, which are compatibility, IT infrastructure, complexity, relative advantage, security, top management support, customer pressure, and competitive pressure. A questionnaire was designed to collect data from 420 SMEs in Palestine. A total of 331 respondents completed and returned the survey. The Partial Least Square-Structural Equation Model (PLS-SEM) approach was used to assess both the measurement and structural models. The Diffusion of Innovation Theory (DOI) and Technology, Organization, and Environment Framework (TOE) framework were employed to identify the determinant factors from the technological, organizational, and environmental perspectives. The findings and conclusions of this study provide show that the moderating effect of firm size has significant effect compatibility, top management support, customer pressure, and IT infrastructure factors.

Stabilization and controlled release of micro-encapsulated hydrogen peroxide for wound treatment applications

AIMS

Hydrogen peroxide (H₂ O₂ ) disinfection applications are limited by its rapid inactivation. The aims of this study were to (i) micro-encapsulate H₂ O₂ in silica hydrogels to obtain controlled release up to 72 h, (ii) test hydrogel antimicrobial activity against four common pathogens and (iii) assess H₂ O₂ release kinetics and antimicrobial activity in 35-65% relative humidity and 37°C to approximate bandaged wound conditions.

METHODS AND RESULTS

Hydrogels were characterized using scanning electron microscopy, nitrogen sorption porosimetry, Brunauer Emmet Teller analysis and the Barret-Joyner-Halenda method. Hydrogels formed at lower pH demonstrated increased surface area and decreased pore size, resulting in H₂ O₂ release lasting 72 h. Using agar well diffusion for antimicrobial activity, statistically significant zones of inhibition (as compared to controls) were seen for Escherichia coli, Staphylococcus aureus, Pseudomona aeruginiosa and Vancomycin-resistant Enterococcus faecalis. Activity remained for hydrogels aged for 72 h in humid, 37°C conditions.

CONCLUSIONS

Hydrogels can be synthesized to provide a continuous, controlled release of H₂ O₂ for up to 72 h.

SIGNIFICANCE AND IMPACT OF THE STUDY

Stable, controlled-release H₂ O₂ hydrogels have potential applications for wound treatment and disinfection of medical equipment, through bonding to bandages or materials such as catheter lumens.

Increasing the availability and quality of caesarean section in Tanzania

OBJECTIVE

To describe the results of increasing availability and quality of caesarean deliveries and anaesthesia in rural Tanzania.

DESIGN

Before-after intervention study design.

SETTINGS

Rural Tanzania.

METHODS

Ten health centres located in rural areas were upgraded to provide comprehensive emergency obstetric care (CEmOC) and the four related district hospitals were supported. Upgrading entailed constructing and equipping maternity blocks, operation rooms and laboratories; installing solar systems, backup generators and water supply systems. Associate clinicians were trained in anaesthesia and in CEmOC. Mentoring and audit of reasons for caesarean section (CS) and maternal deaths were carried out. Measures of interest were compared using analysis of variance (ANOVA) statistical tests.

MAIN OUTCOME MEASURES

Trends in CS rates, proportion of unjustified CS, use of spinal anaesthesia, and the risk of death from complications related to CS and anaesthesia.

RESULTS

During the audit period (2012-2014), 5868 of 58 751 deliveries were by CS (10%). The proportion of CS considered to be unjustified decreased from 30 to 17% in health centres (P = 0.02) and from 37 to 20% in hospitals (P < 0.001). Practice of spinal anaesthesia for CS increased from 10% to 64% in hospitals (P < 0.001). Of 110 maternal deaths, 18 (16.4%) were associated with complications of CS, giving a risk of 3.1 per 1000 CS; three (2.7%) were judged to be anaesthetic-associated deaths with a risk of 0.5 per 1000 caesarean deliveries.

CONCLUSIONS

Increasing availability and quality of CS by improving infrastructure, training and audit of reasons for CS is feasible, acceptable and required in low resource settings.

TWEETABLE ABSTRACT

Increasing availability and quality of CS in rural Africa is feasible.

Assembly PCR synthesis of optimally designed, compact, multi-responsive promoters suited to gene therapy application

Gene therapy has the potential to provide innovative treatments for genetic and non-genetic diseases, with the ability to auto-regulate expression levels of therapeutic molecules so that they are produced locally and in direct response to disease activity. Generating disease responsive gene therapy vectors requires knowledge of the activation profile of transcription factors (TFs) during active disease, in order to assemble binding sites for these TFs into synthetic promoters, which can be appropriately activated by the disease process. In this study, we optimised a PCR random assembly approach to generate promoters with optimal spacing between TF binding sites (TFBSs) and their distance from the TATA box. In promoters with optimal spacing, it was possible to demonstrate activation by individual transcription pathways and either additive or synergistic promoter activation when transfected cells were treated with combined stimuli. The kinetics and sensitivity of promoter activation was further explored in transduced cells and when lentivirus was directly delivered to mouse paws a synthetic promoter demonstrated excellent activation by real-time imaging in response to local inflammation.

An evaluation and selection problems of OSS-LMS packages

The evaluation and selection of inappropriate open source software in learning management system (OSS-LMS) packages adversely affect the business processes and functions of an organization. Thus, comprehensive insights into the evaluation and selection of OSS-LMS packages are presented in this paper on the basis of three directions. First, available OSS-LMSs are ascertained from published papers. Second, the criteria for evaluating OSS-LMS packages are specified.according to two aspects: the criteria are identified and established, followed by a crossover between them to highlight the gaps between the evaluation criteria for OSS-LMS packages and the selection problems. Third, the abilities of selection methods that appear fit to solve the problems of OSS-LMS packages based on the multi-criteria evaluation and selection problem are discussed to select the best OSS-LMS packages. Results indicate the following: (1) a list of active OSS-LMS packages; (2) the gaps on the evaluation criteria used for LMS and other problems (consisting of main groups with sub-criteria); (3) use of multi-attribute or multi-criteria decision-making (MADM/MCDM) techniques in the framework of the evaluation and selection of the OSS in education as recommended solutions.

Challenges and lessons learned from implementing a risk-based approach to school advice and closure during the containment phase of the 2009 influenza pandemic in the West Midlands, England

OBJECTIVE

School closure as a social distancing measure was used in some countries during the initial phases of the influenza A(H1N1)pdm09 pandemic. The objective of this paper is to describe the use of a risk-based approach to public health interventions for schools during the 'containment phase' of the pandemic and to describe lessons learnt.

METHODS

The development of a framework for risk assessment and decision-making to determine school closures in the West Midlands, England, during the 'containment phase' of influenza A(H1N1)pdm09 pandemic is described.

RESULTS

Using the framework developed during the 'containment phase', assessments were conducted for 344 educational institutions who reported confirmed cases or 'particularly high absenteeism'. Of these, 209 (60%) had confirmed cases and 65 were closed, mainly for public health or operational reasons. Schools were closed on an individual basis, during the most intense period of the pandemic and for an average period of six days (maximum 11 days). The risk-based approach evolved as experience and knowledge of influenza A(H1N1)pdm09 pandemic virus increased, however some decisions were difficult to communicate to parents, schools and stakeholders particularly when the number of schools affected escalated and the pandemic response phases changed.

CONCLUSION

The management of school closures is an 'uncertain art'. Numerous challenges and lessons were identified in attempting, during the containment phase of the influenza A(H1N1)pdm09 pandemic, to ensure consistency and transparency in an increasingly complex process. The overall approach described could be further developed to improve decision-making for infectious diseases in schools.

How Effective is Systematic Care of Diabetic Patients?

With the ultimate goal of improving medical care for diabetes, a study of four Primary Healthcare Centers (PHC) surveyed the composition of PHC population, completeness of patient data, changes in biochemical variables two years before and after establishing specialized diabetic clinics. Patients with diabetes of less than four years duration were excluded from the study. Most (71.7%) of 403 patients with Type II diabetes were aged 40-59 years. Diabetes regulation (HbA1 C), lipid levels (total cholesterol), systolic blood pressure and creatinine improved significantly after inclusion in the specialized diabetic clinic demonstrating that the introduction of systematic care for diabetic patients was effective and lead to an improvement in the recorded process measures and outcome criteria.

Adiponectin changes in HCV-Genotype 4: relation to liver histology and response to treatment

Recently, attention has been focussed on adiponectin and its changes in different types of chronic liver disease. Its relation to hepatic fibrosis and insulin resistance in post-hepatitis liver disease is not clear. The aim of this study was to clarify the adiponectin changes in genotype 4 hepatitis C virus (HCV)-infected patient in relation to liver histology and insulin resistance, and its usefulness as a predictor of hepatic fibrosis and response to treatment. Total adiponectin and its high molecular weight (HMW) form as well as insulin levels were studied in 92 chronic HCV, genotype 4 and 66 healthy control volunteers. Neither total adiponectin (r = 0.101, P = 0.220) nor HMW adiponectin (r = 0.081, P = 0.328) correlated with viral load. Total and not HMW adiponectin was significantly correlated with hepatic fibrosis and inflammation (r = 0.267, P = 0.002, r = 0.278, P < 0.001, respectively).In addition, total adiponectin (r = 0.224, P = 0.002) and HMW adiponectin (r = 0.266, P < 0.0006) significantly correlated with insulin resistance. As fibrosis did not correlate with insulin resistance (r = 0.081, P = 0.204), the correlation between total adiponectin and fibrosis was not mediated by insulin resistance. Multivariable regression analysis, (including pretreatment cases and controls) revealed that total adiponectin was significantly associated with gender, being lower among male subjects (X(2) = 13.04, P = 0.0001). The multivariable regression model supported the lack of association between insulin resistance and total adiponectin levels (X(2) = 1.88, P = 0.171), while non cirrhotics had significantly lower total adiponectin levels than cirrhotics (X(2) = 10.90, P = 0.004) and lower level of inflammation significantly lower total adiponectin levels than more severe inflammation (X(2) = 8.95, P = 0.003). Total or HMW adiponectin did not yield receiver operating characteristic (ROC) curves with area under the curve (AUC) >75%, thus the cutoff points have poor sensitivity/specificity as predictors of fibrosis. However, as a predictor of end-of-treatment response, the ROC curve of adiponectin index gave yield an AUC = 81.4%. We can conclude that total adiponectin level, in HCV genotype 4 patients, increases with progression of hepatic fibrosis regardless of insulin resistance. Its high molecular form does not have such correlation. The adiponectin changes are not related to viral load, insulin resistance or other demographic data suggesting that this change is histologically related. In spite of this, no adiponectin cutoff level had reasonable sensitivity/specificity for predicting hepatic fibrosis stage, while this may be used as a predictor for antiviral response possibly reflecting improvement in hepatic inflammation post treatment.