Discovery of Pyrano[2,3-c]pyrazole Derivatives as Novel Potential Human Coronavirus Inhibitors: Design, Synthesis, In Silico, In Vitro, and ADME Studies.

The SARS-CoV-2 pandemic at the end of 2019 had major worldwide health and economic consequences. Until effective vaccination approaches were created, the healthcare sectors endured a shortage of operative treatments that might prevent the infection's spread. As a result, academia and the pharmaceutical industry prioritized the development of SARS-CoV2 antiviral medication. Pyranopyrazoles have been shown to play a prominent function in pharmaceutical chemistry and drug sighting because of their significant bioactive properties. We provide herein a novel sequence of pyranopyrazoles and their annulated systems whose antiviral efficacy and cytotoxicity were explored versus human coronavirus 229E (HCoV-229E) Vero-E6 cell lines as a model for the Coronaviridae family. Fifteen synthetic congeners pointed out miscellaneous antiviral efficacies against HCoV-229E with variable inhibition degrees. Compound 18 showed a high selectivity index (SI = 12.6) that established spectacular inhibitory capacity against human coronavirus 229E. Compounds 6, 7, and 14 exposed moderate efficacies. Compounds 6, 7, 14, and 18 exhibited substantial antiviral action through the replication phase with reduction percentages extending from 53.6%, 60.7%, and 55% to 82.2%, correspondingly. Likewise, when assessed to the positive control tipranavir (88.6%), the inhibitory efficiency of compounds 6, 7, 14, and 18 versus the SARS-CoV2 Mpro provided high percentages of 80.4%, 73.1%, 81.4% and up to 84.5%, respectively. In silico studies were performed to investigate further the biological activity and the target compounds' physical and chemical features, including molecular dynamic (MD) simulations, protein-ligand docking, ADME studies, and density functional theory (DFT) calculations. These inquiries demonstrated that this series of metabolically stable pyranopyrazoles and their annulated systems are effective human coronavirus inhibitors that inhibit the viral Mpro protein and may have emerged as a novel COVID-19 curative option.

Magnetic resonance imaging of pilonidal sinus disease: interobserver agreement and practical MRI reporting tips.

OBJECTIVE: To evaluate the interobserver agreement for the features of natal cleft pilonidal sinus disease (PSD) on magnetic resonance imaging (MRI) and propose a standardized checklist for reporting PSD on MRI. MATERIALS AND METHODS: Forty MRI studies of 39 discrete patients with PSD were retrospectively evaluated by five independent radiologists using a standardized checklist. Fleiss' Kappa (k) coefficients of agreement were used to test the agreement between categorical variables. The MRI features of the natal cleft sepsis associated with PSD were classified into four main categories: morphology, branching and extensions, external skin openings, and the relationship of the PSD to the coccyx. A survey was created and disseminated online among general surgeons who treat patients with PSD to assess the relevance of the MRI features proposed in the standardized checklist. RESULTS: The overall agreement regarding the identification of morphology of the natal cleft sepsis was moderate (k = 0.59). Lateral and caudal extensions interobserver agreement was substantial (k = 0.64 and 0.71, respectively). However, the overall agreement regarding the individual parts of anal sphincter involved was moderate (k = 0.47). Substantial interobserver agreement was found in assessing the proximity of the PSD to the coccyx (k = 0.62). CONCLUSION: Preoperative MRI can delineate the extensions and branching of PSD with substantial agreement. MRI is superior in describing the deep extensions of PSD with better reliability than assessing the number and locations of the external openings. Expert consensus agreement is needed to establish the MRI features necessary for optimal reporting of PSD. CLINICAL RELEVANCE STATEMENT: MRI can offer valuable information about the extent of sepsis associated with pilonidal sinus disease, particularly in cases with involvement of critical anatomical structures such as the coccyx and anal triangle. MRI can potentially contribute to more accurate patient stratification and surgical planning. KEY POINTS: • The interobserver agreement for assessing PSD's lateral and caudal extension on MRI is substantial. • MRI can describe deep extensions and branching of PSD with superior reliability than assessing the number and site of external openings. • Reporting the relationship between natal cleft sepsis in PSD and the anal region may influence the surgical approach and postoperative healing.

New nitazoxanide derivatives: design, synthesis, biological evaluation, and molecular docking studies as antibacterial and antimycobacterial agents.

A new series inspired by combining fragments from nitazoxanide (NTZ) and 4-aminosalicylic acid (4-ASA) was synthesized and screened for in vitro antibacterial and antimycobacterial activities. The majority showed higher antibacterial potency than NTZ against all the screened strains, notably, 5f, 5j, 5n and 5o with MICs of 0.87-9.00 µM. Compounds 5c, 5n and 5o revealed higher potency than ciprofloxacin against K. pneumoniae, while 5i was equipotent. For E. faecalis, 3b, 5j, and 5k showed higher potency than ciprofloxacin. 5j was more potent against P. aeruginosa than ciprofloxacin, while 5n was more potent against S. aureus with an MIC of 0.87 µM. 5f showed equipotency to ciprofloxacin against H. pylori with an MIC of 1.74 µM. Compounds 3a and 3b (4-azidoNTZ, MIC 4.47 µM) are 2 and 5-fold more potent against Mycobacterium tuberculosis (Mtb H37Rv) than NTZ (MIC 20.23 µM) and safer. 4-Azidation and/or acetylation of NTZ improve both activities, while introducing 1,2,3-triazoles improves the antibacterial activity. Molecular docking studies within pyruvate ferredoxin oxidoreductase (PFOR), glucosamine-6-phosphate synthase (G6PS) and dihydrofolate reductase (DHFR) active sites were performed to explore the possible molecular mechanisms of actions. Acceptable drug-likeness properties were found. This study may shed light on further rational design of substituted NTZ as broad-spectrum more potent antimicrobial candidates.

Predictors of recurrence after paclitaxel drug-coated balloon use for treating femoropopliteal in-stent restenosis.

OBJECTIVE: Paclitaxel drug-coated balloon (PDCB) angioplasty has been shown to be an effective treatment of in-stent restenosis (ISR) at the femoropopliteal (FP) arteries. Long-term studies, however, have shown a progressive decrease in the patency rates following PDCB. The aim of this study was to determine the predictors of stenosis recurrence after PDCB treatment of FP-ISR, and its immediate and mid-term outcomes. METHODS: This prospective, non-randomized study included all chronic lower extremity ischemia patients of Rutherford class 3-6 who underwent PDCB angioplasty to treat >50% FP-ISR between June 2017 and December 2019. The primary endpoint was primary patency, defined as freedom from binary restenosis and freedom from clinically driven target lesion revascularization (CD-TLR) at 12 months. Secondary endpoints included 12-months freedom from CD-TLR and major adverse events (MAEs). RESULTS: A total of 73 symptomatic chronic limb ischemia patients (73 limbs including 63 with limb threatening ischemia) underwent PDCB angioplasty of FP-ISR lesions (13.7% Tosaka class I, 54.8% class II, and 31.5% class III). The mean ISR lesion length was 121.8 ± 52.7 mm. Technical success was achieved in 70 (95.9%) patients. Kaplan-Meier estimate of the 12-months rates of primary patency and freedom from CD-TLR was 76.1% and 87.4%, respectively. At one year, MAEs occurred in eight patients (11.0%) including two deaths (2.7%), one major amputation (1.4%), and six (8.2%) surgical revascularizations. Multivariable analysis showed that Tosaka class III ISR (HR 4.51, CI: 1.31-15.53, p < 0.001) and reference vessel diameter (HR 0.38, 95% CI: 0.18-080, p = 0.01) were independently associated with recurrent ISR. CONCLUSIONS: PDCB is safe and effective treatment of FP-ISR lesions. Occlusive ISR lesions and reference vessel diameter were independently associated with recurrent ISR stenosis after PDCB treatment.

Sustainability of Leisure Tourism Events from a Destination Social Responsibility Perspective: Do Attribution Theory Dimensions Matter?

Although Destination Sustainable Responsibility (DSR) has become a critical factor in upholding tourists' satisfaction and positive behavioral outcomes, research on how tourists perceive different attributional dimensions (e.g., controllability, stability) about the existing information adequacy on tourists' behavior is limited. Additionally, no study has investigated how DSR influences leisure tourists' satisfaction across various characteristics. Therefore, the current research has the novelty of examining the effects of Destination Sustainable Responsibility (DSR) on leisure tourists' satisfaction. The study reveals two attribution theory dimensions, controllability, and stability, as mediators and information adequacy as a moderated mediation. Additionally, the study investigates how tourists' personalities (extroverted, conscientious, neurotic, open, and agreeable) affect their perceptions of attribution dimensions. A quantitative analysis of 464 tourists who experienced leisure activities in sustainability resorts in the Red Sea was conducted to explore these relationships. The results provide a better understanding of how DSR affects leisure tourists' satisfaction and how different personalities influence their perceptions. Our research findings demonstrate that tourists' perceptions of destination sustainability initiatives (DSR) are contingent upon the controllability and stability of events and that extraverted and conscientious tourists reach different attributions on DSR than those with neuroticism and openness levels and agreeableness. Additionally, it appears that information adequacy concerning the controllability of events is privileged over the event's stability about informant amount with DSR. We explore the implications of our conclusions from both theoretical and management perspectives.

Duplex-Guided Ipsilateral Antegrade Approach for Flush Superficial Femoral Artery Occlusion.

OBJECTIVE: Recanalization of flush ostial superficial femoral artery (SFA) occlusion is a very challenging procedure. Using the ipsilateral antegrade approach in such lesions has some difficulties. This study aimed to assess the feasibility, efficacy, and outcomes of duplex-guided ipsilateral antegrade access for endovascular treatment of atherosclerotic flush occlusion of the SFA. METHODS: This is a prospective two-center study that included chronic lower extremity ischemia patients with flush occlusion of SFA who underwent duplex-guided ipsilateral antegrade endovascular revascularization due to unfeasible contralateral femoral approach. Flush occlusions were preoperatively documented by duplex ultrasound and computed tomography angiography in all patients. The outcome measures were technical success, patency rates, perioperative morbidity and mortality, limb salvage, and amputation free survival rates. RESULTS: Between April 2019 and March 2021, 49 patients were enrolled in the current study with a mean age of 63.7 ± 5.7 years. Diabetes was the most common risk factor and was found in 40 (81.6%) patients. Associated popliteal lesions were found in seven (14.3%) patients, while 10 (20.4%) patients had combined tibial disease. Selective stenting was done in nine (18.4%) patients. Technical success was achieved in 43 (87.8%) patients. All failures were due to inability to cross the lesion rather than failure to access the common femoral artery. All complications were minor and occurred in seven (14.3%) patients. Primary, assisted primary, and secondary patency rates were 63.9% ± 7.1%, 82.8% ± 5.6%, and 93.5% ± 3.7% at 12 months, respectively. The overall 12-month limb salvage and amputation free survival rates were 91.8% and 83.3% ± 5.4%, respectively. CONCLUSION: Duplex-guided ipsilateral antegrade femoral access is a feasible, safe, and effective endovascular treatment option for flush SFA occlusion when contralateral femoral access is not possible.

Travelers' Subjective Well-Being as an Environmental Practice: Do Airport Buildings' Eco-Design, Brand Engagement, and Brand Experience Matter?

The physical environment of airports plays a crucial role in improving travelers' perceptions and well-being. Adopting a green physical environment may elicit customers' cognitive and emotional responses and provide a convenient consumption environment. Brand experience and engagement are other important consumer-firm interactions that influence the attributes of the passengers' well-being. The current study sought to assess the impact of the eco-design of buildings, brand experience and engagement on the well-being of travelers at an international airport in Saudi Arabia. Additionally, the current study investigated the possible effects of eco-design on airport experience and engagement. The results of the structural equation modeling analysis revealed that the eco-design of airport buildings was independently associated with passengers' well-being and brand engagement, but not with brand experience. Additionally, well-being was significantly predicted by brand engagement and experience. Airport managers are advised to adopt an internal eco-design to help promote passengers' connection with the brand and improve their well-being, which would eventually be reflected in their behavioral attributes and decision-making.

Service Value and Repurchase Intention in the Egyptian Fast-Food Restaurants: Toward a New Measurement Model.

Service value is a crucial dominant indicator in customer decision-making. However, there is a lack of hospitality literature that investigates the multi-dimensional service value in emerging markets. Thus, this study aims to create a multi-dimensional scale for service value and to analyze how different service value dimensions affect customers repurchase intentions at fast-food restaurants. We make a conceptual framework with eight constructs, including service value and repurchase intention. A self-administrated questionnaire is used to gather empirical data from fast-food restaurant customers in Egypt. We employ confirmatory factor analysis to extract the model's reliability and validity. Moreover, we use a structural equation model to extract the model regressions and correlations using AMOS software. We find that each of the eight proposed service value variables impacts fast-food restaurant customers' repurchase intention. However, the factors that strongly influence customers' preferences to make more purchases are service equity, confidence benefits, service quality, and service reputation. We contribute to the literature on hospitality customer value and repurchasing intentions by presenting a comprehensive multi-dimensional service value framework that affects customers' repurchase intentions in fast-food restaurants. Practically, eight service value variables can help managers of fast-food restaurants meet customer needs and gain a competitive advantage. We suggest many crucial recommendations to restaurant managers regarding the priority of the service value constructs. For example, managers should consider service equity, service quality, and service reputations as a priority of the restaurant service value.

Digital-Free Tourism Holiday as a New Approach for Tourism Well-Being: Tourists' Attributional Approach.

Digital-free tourism (DFT) has recently attracted tourism service providers' attention for its benefits in terms of enhancing tourists' experiences and well-being at destinations. DFT refers to tourists who are likely to voluntarily avoid digital devices and the Internet on holiday, or travel to destinations without network signals. DFT has advantages for tourists in increasing well-being, mental health, and social networking during their journeys. DFT also has a benefit for tourism marketers in that they can consider it as a new tourism approach. However, there is a lack of studies into tourists' locus of control (LOC) while experiencing DFT holidays. LOC refers to how individuals assign the responsibility of event outcomes-whether they assign it to themselves (internal LOC) or they say it is beyond their control (external LOC). Therefore, the current study contributes to investigating tourists' LOC impacts while experiencing DFT holidays. The study relies on semi-structured interviews with millennial tourists who have experienced DFT holidays. The study findings reveal that millennial tourists with an internal LOC (vs. external) are more likely to perceive the DFT advantages (vs. obstacles) during and after the DFT holidays. However, millennial tourists with external LOC incrementally change their attitudes and perceive the DFT holiday benefits through their self-efficacy enhancement. The findings propose managerial strategies for developing effective DFT holidays for millennial tourists regarding their LOC.

An integrated microfluidic electrochemical assay for cervical cancer detection at point-of-care testing.

Cervical cancer (CC) is a major health care problem in low- and middle-income countries, necessitating the development of low-cost and easy-to-use assays for CC detection at point-of-care (POC) settings. An integrated microfluidic electrochemical assay for CC detection, named IMEAC, is presented that has the potential for identifying CC circulating DNA in whole blood samples. The IMEAC consists of two main modules: a plasma separator device that isolates plasma from whole blood with high purity and without the need for any external forces connected to a graphene oxide-based electrochemical biosensor that uses specific probe molecules for the detection of CC circulating DNA molecules. We fully characterize the performance of the individual modules and show that the integrated assay can be utilized for target DNA detection in whole blood samples, thus potentially transforming CC detection and screening at remote locations.

The Relationship Between the Global Limb Anatomic Staging System (GLASS) and Midterm Outcomes of Retrograde Tibiopedal Access After Failure of Antegrade Recanalisation for Chronic Limb Threatening Ischaemia.

OBJECTIVE: To examine the relationship between the Global Limb Anatomic Staging System (GLASS) and midterm limb and survival related outcomes of retrograde tibiopedal access, after failed recanalisation of infrainguinal chronic total occlusions (CTOs) using the antegrade approach, in patients with chronic limb threatening ischaemia (CLTI). METHODS: This prospective, observational study was conducted between January 2017 and April 2019, and included 213 patients (29 GLASS I, 53 GLASS II, and 131 GLASS III lesions) with infrainguinal CTO in whom a percutaneous tibiopedal access was attempted following failed recanalisation using an antegrade approach. Multivariable Cox proportional hazard regression was performed to assess possible predictors of midterm clinical outcomes. Kaplan-Meier survival curves were used to estimate limb based patency (LBP), limb salvage, amputation free survival (AFS), and overall survival. RESULTS: The study reported access, crossing, and treatment success of 92.5%, 89.2%, and 89.2% of all tibiopedal access attempts, respectively. In comparison with GLASS I, GLASS stage III was associated with statistically significantly worse midterm LBP (p = .005), overall survival (p = .037), limb salvage (p = .021), and AFS (p < .001). CONCLUSION: Retrograde tibiopedal access for recanalisation of infrainguinal CTOs in patients with CLTI is associated with high access, crossing, and treatment success, and low complication rates. The study suggests that GLASS stage may be a useful predictor of midterm limb and survival related outcomes of this approach. In comparison with GLASS I, GLASS III anatomy is associated with a statistically significantly worse LBP, limb salvage, AFS, and overall survival.

High adsorption capacity of phenol and methylene blue using activated carbon derived from lignocellulosic agriculture wastes.

The resources of clean water worldwide are very limited, and climate change is already affecting the available supplies. Therefore, developing a low-cost, highly efficient, and recyclable adsorbent to upgrade water quality has become an essential task. Herein, we report the fabrication of activated carbon (AC) adsorbents derived from lignocellulosic wastes. Both physical and chemical activation were investigated to modify the surface texture properties. The results indicated that increasing the activation temperature, whether physically or chemically, increases the specific surface area (SBET). On the contrary, increasing the amount of the chemical activating agent significantly decreases the SBET values. The SBET of 1771, 2120, and 2490 m2 g-1 were obtained for water vapor, K2CO3 and KOH, at activation temperatures of 950 °C, 800 °C, and 800 °C, respectively. Methylene blue (MB) and phenol were used as adsorbates for the adsorption experiment. Adsorption of methylene blue dye revealed the ability of the water activated carbon to remove more than 95% of the dye (100 ppm) within 5 min with an adsorption capacity of 148.8 mg g-1. For phenol adsorption, Several parameters were investigated, including initial concentration (50-250 ppm), pH (2-10), contact time (5-60 min), and temperature (25-45 °C). The highest adsorption capacity of phenol achieved was 158.9 mg g-1. The kinetics of adsorption of phenol was better described by pseudo-second-order reaction while the isotherm process using Langmuir model. This study presents a roadmap for conversion of lignocellulosic biomass waste into highly efficient porous carbon adsorbents.

Role of MicroRNA-223 and MicroRNA-182 as Novel Biomarkers in Early Detection of Colorectal Cancer.

Background: Colorectal cancer is a common and lethal disease. It is estimated that approximately 145,600 new cases of large bowel cancer are diagnosed annually in the USA. MiRNA-223 and miRNA-182 have been reported in various cancers, such as lung, gastric, breast and colorectal cancer and proposed to be valid and reliable for diagnosis as well as prognosis. Aim: This study aimed to determine the role of miR-223 and miR-182 as novel biomarkers for early detection and prognosis of CRC. Patient and Methods: This case-control study was conducted at the department of Internal Medicine, Aswan University Hospital, in the period from the 1st of February 2020 to the 20th of April 2021. Thirty-five cases and thirty age- and sex-matched controls were included in the study. All patients were subject to complete clinical evaluation, routine investigations, occult blood in stool, serum levels of CEA and CA 19-9, serum levels of miR-223 and miR-182 by quantitative PCR. Results: Significant difference between the two studied groups regarding biomarker changes was found. ROC curve analysis showed that the new markers had excellent diagnostic as well as prognostic criteria. Micro-RNA-223 diagnostic accuracy, sensitivity, specificity, PPV, NPV, FDR and FOR were 97%, 97.1%, 96.7%, 97%, 97%, 3.3% and 2.9%, respectively. Also, micro-RNA-182 diagnostic accuracy, sensitivity, specificity, PPV, NPV, FDR and FOR were 97%, 98%, 96%, 96%, 98%, 3.9% and 2%, respectively. Conclusion: MiR-223 and miR-182 have been discovered to be relevant and reliable biomarkers for the early identification and prognosis of CRC. Increased levels of miR-223 and miR-182 were associated with increased risk of disease progression, and the more accurate the value of miR-223 and miR-182, the earlier the diagnosis of colorectal cancer.

Empowerment Predicting Nurses' Work Motivation and Occupational Mental Health.

INTRODUCTION: Empowering nurses is essential for improving work outcomes, and understanding the role of structural and psychological empowerment in supporting nurses' work motivation and occupational mental health are essential to stimulate nurses' productivity and preserve their mental health. OBJECTIVES: To evaluate nurses' perspectives about the levels of structural and psychological empowerment in their working areas. Additionally, to evaluate nurses' motivation and occupational mental health, and to predict the nurses' motivation and occupational mental health through structural and psychological empowerment. METHODS: A descriptive correlational design and quota sampling were used. Two hundred registered nurses were recruited from two hospitals in Jordan. Data were collected using four valid and reliable self-report questionnaires. RESULTS: Nurses who participated in this study were young and have an average total experience in nursing of fewer than 10 years. Nurses in this study reported a moderate level of structure empowerment and a low level of psychological empowerment. Significant positive relationships were documented between both structural, psychological empowerment, and nurses' work motivation (r = 0.85), (r = 0.83) respectively. A significant negative relationship found between both structural, psychological empowerment, and nurses' occupational mental health (r = -0.31), (r = -0.29) respectively. CONCLUSIONS: The levels of nurses' work motivation and occupational mental health can be predicted through the levels of structural and psychological empowerment. The higher workplace empowerment was associated with increased work motivation, as well as reduced the feeling of occupational stress among nurses. Thus, administrators should invest in fostering structural and psychological empowerment in the work environment.

Is it essential to remove the submandibular gland in neck dissection in tongue cancer patients?

INTRODUCTION: Submandibular sialadenectomy is a part of the classic technique of neck dissection for oral cavity cancers. However, its removal is associated with a reduction in the salivary outflow in many patients, as well as, some uncommon complications such as lingual and hypoglossal nerve injuries. Assessment of the necessity of such maneuvers should be addressed. PATIENTS AND METHODS: The data of 105 patients with tongue cancer who underwent neck dissection in the Oncology Center, Mansoura University from January 2008 to March 2019 were reviewed and analyzed retrospectively. RESULTS: In all the included patients, whether showing pathologic positive or negative lymph nodes, none showed capsular or parenchymal submandibular gland metastasis except for one patient who showed direct infiltration of the gland by the primary tumor. CONCLUSION: Submandibular sialadenectomy may not be indicated as a part of neck dissection in tongue cancer patients. Further research should be conducted to focus on the effect of its preservation on disease-free and overall survival.

Operative Outcomes of Single-Incision Laparoscopic Hysterectomy vs Conventional Laparoscopic Total Hysterectomy: A Prospective Randomized Controlled Study.

Background. Over time, there was an emerging need to shift from laparotomy to minimally invasive laparoscopic surgery, with the success of laparoscopic surgery in the last decade in gyne-oncology. Patients and Methods. This is a prospective randomized controlled trial conducted in Surgical Oncology Unit, Oncology Centre, Mansoura University, in the period between February 2016 and October 2019. Fifty female patients planned for total hysterectomy were randomized into two equal groups; the first underwent conventional laparoscopic hysterectomy (CLH), while the second underwent single-incision laparoscopic hysterectomy (SILH). Results. The mean operative time in the SILH group was 120.00 ± 28.72 minutes vs 103.20 ± 23.04 minutes in the CLH group (P= .027). Median hospital stay in the SILH group was 1 day (range: 1-3 days), the same as that in the CLH group, with no statistical significance (P= .384). Postoperative pain assessment using the Visual Analogue Scale (VAS) after 6 hours had a median score of 6 (2-8) in the SILH group and 6 (4-7) in the CLH group with significant increase in experienced pain in the SILH group (P= .004), while no significant difference was noted after 12 hours and 24 hours in both SILH and CLH groups. Conclusion. Single-incision laparoscopic hysterectomy (SILH) has similar outcomes when compared to conventional laparoscopic hysterectomy as regard blood loss, hospital stay, conversion to laparotomy, intraoperative and postoperative complications with the disadvantages of longer operative time, increased surgeon's workload, and relatively more postoperative pain.

Safety and Efficacy of Hybrid Angiography in Chronic Lower Extremity Ischemia Patients at Risk of Contrast-Induced Acute Kidney Injury.

AIM: The aim of the study was to assess the feasibility and safety of hybrid angiography consisting of carbon dioxide (CO2) angiography supplemented by small doses of iodinated contrast medium (ICM) in the endovascular treatment of chronic limb threatening ischemia (CLTI) patients with pre-existing chronic kidney disease (CKD). PATIENTS AND METHODS: This prospective study comprised all non-dialysis-dependent CKD patients presenting for endovascular management of CLTI. All endovascular interventions were done using CO2 as a contrast medium whether alone or supplemented by ICM (hybrid angiography) to treat unilateral arterial steno-occlusive lesions of iliac, femoropopliteal, or BTK arteries. Study outcomes included feasibility of the device, technical success, and freedom from contrast-induced acute kidney injury (CI-AKI), renal replacement therapy, and CO2 angiography-related complications. RESULTS: A total of 206 CKD patients underwent endovascular intervention using CO2 only as a contrast medium (159 patients, 77.2%), or hybrid CO2-ICM angiography (47 patients, 22.8%). The overall technical success was 95.6%. Patients were followed up for a mean period of 17.9 ± 4.6 months. The mean volumes of CO2, and ICM consumption were 200.7 ± 95.1 mL, and 11.8 ± 4.4 mL, respectively. The mean procedural, and fluoroscopy times were 95.6 ± 12.5 and 49.5 ± 10.8 minutes, respectively. BTK lesions were significantly associated with the need for hybrid angiography (P = <.0001). The mean pre- and postoperative serum creatinine levels were comparable (P = .08). Two patients (4.3%) showed transient manifestations of CI-AKI, but neither required renal replacement therapy. No statistically significant differences were encountered between the two study groups regarding procedure outcomes. CONCLUSION: Hybrid CO2-ICM angiography is safe, feasible, effective, and a fairly simple alternative during endovascular interventions to treat chronic lower extremity ischemia. Using supplemental small volumes of ICM to overcome the suboptimal images generated by CO2 alone does not jeopardize the renal functions in CKD patients.

Graphitic Carbon Nitride Nanoheterostructures as Novel Platforms for the Electrochemical Sensing of the Chemotherapeutic and Immunomodulator Agent MTX.

We report on the electrochemical determination of one the most effective and widely used chemotherapeutic, anti-inflammatory, and immunomodulator agents, methotrexate (MTX), using low-cost, green, and facile one-pot prepared graphitic carbon nitride (g-CN ) nanosheets. The g-CN nanosheets have been characterized utilizing Fourier transform infrared spectroscopy, X-ray diffraction(XRD), scanning electron microscopy(SEM), and density functional theory (DFT). In comparison to the bare carbon paste electrode (CPE), the g-CN -modified electrode showed a spectacular enhancement in the electrochemical oxidation and detection abilities of MTX. The proposed material exhibits very low limits of detection (12.45 nM) and quantification (41.5 nM), while possessing a wide linear range of 0.22-1.11 µM and 1.11-27.03 µM under optimized conditions at pH 7.0. Due to the ease of preparation of g-CN, it can be adopted for the cost-effective detection of MTX in industrial and clinical analyses.

Sensitive Determination of SARS-COV-2 and the Anti-hepatitis C Virus Agent Velpatasvir Enabled by Novel Metal-Organic Frameworks.

Herein, we report on the electrochemical determination of velpatasvir (VLP) as the main constituent of Epclusa, a SARS-COV-2 and anti-hepatitis C virus (HCV) agent, using a novel metal-organic framework (MOF). The NH2-MIL-53(Al) MOF was successfully modified with 5-bromo-salicylaldehyde to synthesize 5-BSA=N-MIL-53(Al) MOF. The synthesized MOF has been characterized using Fourier transform infrared spectroscopy, X-ray powder diffraction, scanning electron microscopy, cyclic voltammetry, square wave voltammetry, and electrochemical impedance spectroscopy. The modified MOF showed higher electrochemical activity and response than the bare NH2-MIL-53(Al) MOF. Compared to the bare carbon paste electrode (CPE), the 5-BSA=N-MIL-53(Al)/CPE platform was shown to enhance the electrochemical oxidation and detection of the anti-SARS-COV-2 and anti-HCV agent. Under optimized conditions, the 5-BSA=N-MIL-53(Al)/CPE platform showed a linear range of 1.11 × 10-6 to 1.11 × 10-7 and 1.11 × 10-7 to 25.97 × 10-6 M Britton-Robinson buffer (pH 7) with a detection limit and limit of quantification of 8.776 × 10-9 and 2.924 × 10-8 M, respectively. Repeatability, storage stability, and reproducibility in addition to selectivity studies and interference studies were conducted to illustrate the superiority of the electrode material. The study also included a highly accurate platform for the determination of VLP concentrations in both urine and plasma samples with reasonable recovery.

Assessment of the Anti-Cancer Efficiency of Silver Moringa oleifera Leaves Nano-extract against Colon Cancer Induced Chemically in Rats.

BACKGROUND: Colorectal cancer (CRC) categorized as the most common type of gastrointestinal cancers affected both genders equally. Chemotherapeutic drugs became limited due to their deleterious side effects. Therefore, efficiency of M. oleifera leaves extract increased by incorporating silver nanoparticles (Ag-NPs) then studied against colon cancer induced by azoxymethane (AOM) in rats. METHODS: Different hematological and biochemical measurements in addition to specific tumor and inflammatory markers were quantified. Histopathological examination for Colonic tissues was performed. Native proteins and isoenzyme patterns were electrophoretically detected in addition to assaying expression of Tumor Protein P53 (TP53) and Adenomatous Polyposis Coli (APC) genes in colonic tissues. RESULTS: M. oleifera nano-extract restored levels of the hematological and biochemical measurements in addition to levels of tumor and inflammatory markers to normalcy in both of nano-extract simult- and post-treated groups. Also, it minimized severity of the histopathological alterations in the simult-treated group and prevented it completely in the post-treated group. The lowest similarity index (SI%) values were noticed with electrophoretic protein (SI=61.54%), lipid (SI=0.00%) and calcium (SI=75.00%) moieties of protein patterns, catalase (SI=85.71%), peroxidase (SI=85.71%), α-esterase (SI=50.00%) and ß-esterase (SI=50.00%) isoenzymes in addition to altering the relative quantities of total protein and isoenzyme bands in colon of cancer induced group. Moreover, levels of TP53 and APC gene expression increased significantly (P≤0.05) in colon cancer induced group. The nano-extract prevented the qualitative and quantitative alterations in the different electrophoretic patterns in addition to restoring levels of the gene expressions to normalcy in both of simult- and post-treated groups. CONCLUSION: M. oleifera nano-extract exhibited ameliorative effect against the biochemical, physiological and molecular alterations induced by AOM in nano-extract simult- and post-treated groups.
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