Bovine Serum Albumin Template-Mediated Fabrication of Ruthenium Dioxide/Multiwalled Carbon Nanotubes: High-Performance Electrochemical Dopamine Biosensing in Human Serum.

The presence of abnormal dopamine (DA) levels may cause serious neurological disorders, therefore, the quantitative analysis of DA and its related research are of great significance for ensuring health. Herein, the bovine serum albumin (BSA) template method has been proposed for the preparation of catalytically high-performance ruthenium dioxide/multiwalled carbon nanotube (RuO2/MWCNT) nanocomposites. The incorporation of MWCNTs has improved the active surface area and conductivity while effectively preventing the aggregation of RuO2 nanoparticles. The outstanding electrocatalytic performance of RuO2/MWCNTs has promoted the electro-oxidation of DA at neutral pH. The electrochemical sensing platform based on RuO2/MWCNTs has demonstrated a wide linear range (0.5 to 111.1 µM), low detection limit (0.167 µM), excellent selectivity, long-term stability, and good reproducibility for DA detection. The satisfactory recovery range of 94.7% to 103% exhibited by the proposed sensing podium in serum samples signifies its potential for analytical applications. The aforementioned results reveal that RuO2/MWCNT nanostructures hold promising aptitude in the electrochemical sensor to detect DA in real samples, further offering broad prospects in clinical and medical diagnosis.

Colorimetric platform based on synergistic effect between bacteriophage and AuPt nanozyme for determination of Yersinia pseudotuberculosis.

The development of a novel colorimetric method is reported, using vB_YepM_ZN18 phages along with AuPt nanozyme for the sensitive detection of Y. pseudotuberculosis. The phage used in this work has been extracted from hospital sewer water and is highly specific toward Y. pseudotuberculosis. The synthesized AuPt NPs possess peroxidase-like activity, which is suitable in the development of nanozyme based detection system. Furthermore, phages@MB and AuPt@phages are added into the bacterial samples for co-incubation, forming an intercalated complex. The magnetic separation and absorbance analysis of enzymatic reaction are carried out for the detection of targeted bacteria. The proposed method has a limit of detection of 14 CFU/mL, a wide linear range from 2.50 × 101 ~ 2.50 × 107 CFU/mL and the assay completion time is 40 min. Benefitting from the outperformance of this sensor, we have successfully employed the developed sensing platform for the detection of Y. pseudotuberculosis in food industry and hospital specimens.

Prosthetic complications with dental implants: a bibliometric analysis of 20 topcited articles.

The purpose of this review was to explore the 20 most cited articles on prosthetic complications with dental implants. Identification of such articles could be helpful in prosthodontics residency programmes in devising the curriculum of essential reading material in implantology. The Institute for Scientific Information, Web of Science Database, and Google Scholar were used to identify the 20 top-cited articles published in journals from 1980 till June 2021. These articles were then evaluated according to the number of citations, authors, study design, publication year, and publishing journal. Descriptive statistics were computed for bibliometrics. It was observed that the citation count ranged from 6,391 to 315 (in descending order). The Toronto study is the most cited study on dental implant prosthetic complications. Prospective studies and systematic and narrative reviews were the predominant study designs used in the articles; however, alarmingly no randomised controlled trials were included in the list.

The role of vitamin D supplementation in augmenting IFN-γ production in response to mycobacterium tuberculosis Infection: A randomized controlled trial.

Vitamin D supports the immune system fight TB by inhibiting Interferon-gamma (IFN-γ) and lowering host inflammation. The purpose of the research was to see if giving the vitamin D supplements to TB patients affected their prognosis. A randomized placebo control study of 200 TB patients was performed among which 106 received 400,000 IU of injectable vitamin D3 and 94 received placebo for 2 doses. Assessment was carried out at the end of every month for 3 months. IFN-γ responses to whole blood stimulation generated by the Mycobacterium tuberculosis sonicate (MTBs) antigen and early secreted and T cell activated 6 kDa (ESAT6) were assessed at 0 and 12 weeks. The statistical analysis used descriptive statistics (mean and standard deviation), Friedman's test and Fisher's test. The vitamin D group gained significantly more weight (+3.90 pounds) and had less persistent lung disease on imaging (1.33 zones vs. 1.84 zones). They also had a 50% decrease in cavity size. Additionally, patients with low baseline serum concentrations of 25-(OH)D had a significant increase in MTB-induced IFN-γ production after taking vitamin D supplements. Vitamin D administration in large amounts can hasten the recovery of TB patients. The findings point is a therapeutically useful activity of Vitamin D's in the management for tuberculosis.

Turning the Page: Advancing Detection Platforms for Sulfate Reducing Bacteria and their Perks.

Sulfate reducing bacteria (SRB) are blamed as main culprits in triggering huge corrosion damages by microbiologically influenced corrosion. They obtained their energy through enzymatic conversion of sulfates to sulfides which are highly corrosive. However, conventional SRB detection methods are complex, time-consuming and are not enough sensitive for reliable detection. The advanced biosensing technologies capable of overcoming the aforementioned drawbacks are in demand. So, nanomaterials being economical, environmental friendly and showing good electrocatalytic properties are promising candidates for electrochemical detection of SRB as compared with antibody based assays. Here, we summarize the recent advances in the detection of SRB using different techniques such as PCR, UV visible method, fluorometric method, immunosensors, electrochemical sensors and photoelectrochemical sensors. We also discuss the SRB detection based on determination of sulfide, typical metabolic product of SRB.

The evolving role of digital media in medical education.

Within the last decade, social media has progressed from a form of mere entertainment to a medium for solution of complex issues in our daily lives. During the last few years, social media has gained value in medical education and the diversity in the use of digital media has given new dimensions to medical education while facing the Covid pandemic. Digital media helps in creating virtual communities which not only bring more harmony between teachers and students but has also shown to have reduced anxiety and stress among students. Common social media platforms such as Facebook and WhatsApp have recently gained popularity as platforms which are being actively used in various ways to enhance learning. Social media in medical education is also utilised to enhance communication skills, professionalism and better patient care, but this should be addressed with caution as violation of patient's privacy and confidentiality remains a threat.

Clinicians as Leaders: Impact and Challenges.

Healthcare has always been a complex system phenomenon which needs accountability from the leading clinical and management roles. Adequate and competent leadership is recognized as a driving point for a successful healthcare division. Medical professionals taking charge for quality improvement are well placed yet the style to deliver their leadership qualities bears a massive significance. While exceptional clinical prowess is of tremendous importance, harmonious teamwork, inefficiency reduction and patient communication and safety lead to noteworthy health management outcomes. Explores not explains the importance of leadership, qualities and styles of a leader, various leadership theories, the impact of leadership in medical education and the current issues related to medical leadership.

Trends in biosensing platforms for SARS-CoV-2 detection: A critical appraisal against standard detection tools.

In this ongoing theme of coronavirus disease 2019 (COVID-19) pandemic, highly sensitive analytical testing platforms are extremely necessary to detect SARS-CoV-2 RNA and antiviral antibodies. To limit the viral spread, prompt and precise diagnosis is crucial to facilitate treatment and ensure effective isolation. Accurate detection of antibodies (IgG and IgM) is imperative to understand the prevalence of SARS-CoV-2 in public and to inspect the proportion of immune individuals. In this review, we demonstrate and evaluate some tests that have been used commonly to detect SARS-CoV-2. These include nucleic acid and serological tests for the detection of SARS-CoV-2 RNA and specific antibodies in infected people. Moreover, the vitality of biosensing technologies emphasizing on optical and electrochemical biosensors toward the detection of SARS-CoV-2 has also been discussed here. The early diagnosis of COVID-19 based on detection of reactive oxygen species overproduction because of virus-induced dysfunctioning of lung cells has also been highlighted.

Hierarchical CNTs@CuMn Layered Double Hydroxide Nanohybrid with Enhanced Electrochemical Performance in H2S Detection from Live Cells.

The precise monitoring of H2S has aroused immense research interest in the biological and biomedical fields since it is exposed as a third endogenous gasotransmitter. Hence, there is an urgent requisite to explore an ultrasensitive and economical H2S detection system. Herein, we report a simple strategy to configure an extremely sensitive electrochemical sensor with a 2D nanosheet-shaped layered double hydroxide (LDH) wrapped carbon nanotubes (CNTs) nanohybrid (CNTs@LDH), where a series of CNTs@CuMn-LDH nanohybrids with varied amounts of LDH nanosheets grafted on a conductive CNTs backbone has been synthesized via a facile coprecipitation approach. Taking advantage of the unique core-shell structure, the integrated electrochemically active CuMn-LDH nanosheets on the conductive CNTs scaffold, the maximum interfacial collaboration, and the superior specific surface area with a plethora of surface active sites and ultrathin LDH layers, the as-prepared CNTs@CuMn-LDH nanoarchitectures have exhibited superb electrocatalytic activity toward H2S oxidation. Under the optimum conditions, the electrochemical sensor based on the CNTs@CuMn-LDH nanohybrid shows remarkable sensing performances for H2S determination in terms of a wide linear range and a low detection limit of 0.3 nM (S/N = 3), high selectivity, reproducibility, and durability. With marvelous efficiency achieved, the proposed sensing platform has been practically used in in situ detection of abiotic H2S efflux produced by sulfate reducing bacteria and real-time in vitro tracking of H2S concentrations from live cells after being excreted by a stimulator which in turn might serve as early diseases diagnosis. Thus, our core-shell hybrid nanoarchitectures fabricated via structural integration strategy will open new horizons in material synthesis, biosensing systems, and clinical chemistry.

Advancements in electrochemical sensing of hydrogen peroxide, glucose and dopamine by using 2D nanoarchitectures of layered double hydroxides or metal dichalcogenides. A review.

This review (with 105 references) describes the progress that has been made in the past few years in the use of 2D nanoarchitectures in electrochemical sensors for the clinically highly significant parameters hydrogen peroxide, glucose and dopamine. Following an introduction into the field, we summarize the improvements in electrochemical sensors that can be accomplished by using such nanomaterials, with a specific focus on sensors for in-vitro diagnostics. A further large section covers sensors based on the use of layered double hydroxides (LDHs), with subsections on sensors for hydrogen peroxide, glucose and dopamine. Dichalcogenides based electrochemical sensors are treated in next section, again with subsections on hydrogen peroxide, glucose and dopamine. We also summarize key sensor parameters including limits of detection, linear ranges and real time applications in pharmaceutical, environmental and clinical fields. The next section summarizes the work related to sensing of hydrogen peroxide released from different live cells as signalling molecule indicating cellular stress. The review concludes with a discussion of current challenges and future perspectives. Graphical abstract Schematic illustration of layered double hydroxides (LDHs) and dichalcogenides based electrochemical sensors for sensitive determination of hydrogen peroxide (H2O2), glucose and dopamine (DA) from biological fluids as biomarkers for early diagnosis.

Nanocomposites consisting of copper and copper oxide incorporated into MoS4 nanostructures for sensitive voltammetric determination of bisphenol A.

A nanocomposite (NC) of type Cu/Cu2O/CuO@MoS4 was obtained via coprecipitation and a hydrothermal approach from copper oxide nanoparticles and MoS4 nanostructures. A series of nanocomposites has been fabricated with varying fractions of MoS4. The NCs were characterized by XRD, XPS, SEM and TEM. The synergistic effect of enlarged specific surface, high electrocatalytic activity and the presence of mixed valencies strongly enhance the redox response at the interface of a glassy carbon electrode (GCE) modified with the NC. The intercalation properties of MoS4 in the NCs result in outstanding electro-oxidative performance towards bisphenol A (BPA). The modified GCE, best operated at +0.16 V vs. SCE, has a linear response in the 0.0001 µM to 17 µM BPA concentration range (R2 = 0.998) and high sensitivity (1587 mA µM-1 cm-2). The sensor can detect BPA with very good selectivity, enhanced storage stability and a low detection limit of 0.10 nM (S/N = 3). This is the lowest value among the non-enzymatic biosensors reported until now. The sensor was used for real-time in-vitro monitoring of BPA in (spiked) serum samples. Graphical abstract Schematic representation of Cu/Cu2O/CuO@MoS4 hybrid material fabricated by a hydrothermal method for sensitive determination of bisphenol A (BPA) from biological fluids.

Superlattice stacking by hybridizing layered double hydroxide nanosheets with layers of reduced graphene oxide for electrochemical simultaneous determination of dopamine, uric acid and ascorbic acid.

A self-assembled periodic superlattice material was obtained by integrating positively charged semiconductive sheets of a Zn-NiAl layered double hydroxide (LDH) and negatively charged layers of reduced graphene oxide (rGO). The material was used to modify a glassy carbon electrode which then is shown to be a viable sensor for the diagnostic parameters dopamine (DA), uric acid (UA) and ascorbic acid (AA). The modified GCE displays excellent electrocatalytic activity towards these biomolecules. This is assumed to be due to the synergistic effects of (a) excellent interfacial electrical conductivity that is imparted by direct neighboring of conductive rGO to semiconductive channels of LDHs, (b) the superb intercalation feature of LDHs, and (c) the enlarged surface with an enormous number of active sites. The biosensor revealed outstanding electrochemical performances in terms of selectivity, sensitivity, and wide linear ranges. Typically operated at working potentials of -0.10, +0.13 and + 0.27 V vs. saturated calomel electrode, the lower detection limits for AA, DA and UA are 13.5 nM, 0.1 nM, and 0.9 nM, respectively, at a signal-to-noise ratio of 3. The sensor was applied to real-time tracking of dopamine efflux from live human nerve cells. Graphical abstract Schematic of the preparation of a superlattice self-assembled material by integrating positively charged semiconductive sheets of Zn-NiAl layered double hydroxide (LDH) with negatively charged reduced graphene oxide (rGO) layers. It was applied to simultaneous electrochemical detection of dopamine (DA), uric acid and ascorbic acid.

Dietary practices of school children in Sindh, Pakistan.

BACKGROUND: Malnutrition in Pakistan has remained an unresolved issue for decades. Data on nutrient intake and variety in children's diet is lacking. AIM: This paper describes the dietary practices of school children across eight districts of Sindh. METHODS: A school-based survey of dietary practices among 1109 students from classes 2-5 in 36 schools was conducted using a pre-tested interviewer-completed questionnaire. RESULTS: Descriptive and comparative analysis of data showed that more than 75% school children ate breakfast, lunch and dinner regularly. However, 10% children skipped breakfast and nearly one-third of them skipped mid-morning and evening snacks. Skipping breakfast and snacks was related to low socio-economic status and rural residence. Children's intake of protein-rich food items and fruits also illustrated that urban residence and better socio-economic status have a positive effect on the frequency and variety of daily protein and fruit intake. Though affordability and geographic location were key determinants of children's dietary practices, significantly higher percentages of children studying in class 2, 3 and 4 consumed different kinds of protein-rich food items, fruits and vegetables more frequently as opposed to children studying in class 5. Junk food consumption was more common in urban areas and better socio-economic strata. CONCLUSION: Development of school-based nutrition education programmes and behavior change strategies emphasizing the regular intake of meals and nutrient-rich snacks, and encouraging consumption of easily available and affordable food items such as dried seeds, fruits, vegetables, milk and its derivatives is essential for addressing nutrient deficiencies.

The genomic CDS sandbox: An assessment among domain experts.

Genomics is a promising tool that is becoming more widely available to improve the care and treatment of individuals. While there is much assertion, genomics will most certainly require the use of clinical decision support (CDS) to be fully realized in the routine clinical setting. The National Human Genome Research Institute (NHGRI) of the National Institutes of Health recently convened an in-person, multi-day meeting on this topic. It was widely recognized that there is a need to promote the innovation and development of resources for genomic CDS such as a CDS sandbox. The purpose of this study was to evaluate a proposed approach for such a genomic CDS sandbox among domain experts and potential users. Survey results indicate a significant interest and desire for a genomic CDS sandbox environment among domain experts. These results will be used to guide the development of a genomic CDS sandbox.

Who is excluded and how? An analysis of community spaces for maternal and child health in Pakistan.

BACKGROUND: The maternal, newborn, and child health (MNCH) indicators of Pakistan depict the deplorable state of the poor and rural women and children. Many MNCH programmes stress the need to engage the poor in community spaces. However, caste and class based hierarchies and gendered social norms exclude the lower caste poor women from accessing healthcare. To find pathways for improving the lives of the excluded, this study considers the social system as a whole and describes the mechanisms of exclusion in the externally created formal community spaces and their interaction with the indigenous informal spaces. METHODS: The study used a qualitative case study design to identify the formal and informal community spaces in three purposively selected villages of Thatta, Rajanpur, and Ghizer districts. Community perspectives were gathered by conducting 37 focus group discussions, based on participatory rural appraisal tools, with separate groups of women and men. Relevant documents of six MNCH programmes were reviewed and 25 key informant interviews were conducted with programme staff. RESULTS: We found that lower caste poor tenants and nomadic peasants were excluded from formal and informal spaces. The formal community spaces formed by MNCH programmes across Pakistan included fixed, small transitory, large transitory, and emerging institutional spaces. Programme guidelines mandated selection of community notables in groups/committees and used criteria that prevented registration of nomadic groups as eligible clients. The selection criteria and adverse attitude of healthcare workers, along with inadequacy of programmatic resources to sustain outreach activities also contributed to exclusion of the lower caste poor women from formal spaces. The informal community spaces were mostly gender segregated. Infrequently, MNCH information trickled down from the better-off to the lower caste poor women through transitory interactions in the informal domestic sphere. CONCLUSION: A revision of the purpose and implementation mechanisms for MNCH programmes is mandated to transform formal health spaces into sites of equitable healthcare.

Bridging biological and food monitoring: A colorimetric and fluorescent dual-mode sensor based on N-doped carbon dots for detection of pH and histamine.

Rapid and sensitive monitoring of pH and histamine is crucial for bridging biological and food systems and identifying corresponding abnormal situations. Herein, N-doped carbon dots (CDs) are fabricated by a hydrothermal method employing dipicolinic acid and o-phenylenediamine as precursors. The CDs exhibit colorimetric and fluorescent dual-mode responses to track pH and histamine variations in living cells and food freshness, respectively. The aggregation-induced emission enhancement and intramolecular charge transfer result in a decrease in absorbance and an increase in fluorescence, which become readily apparent as the pH changes from acidic to neutral. This property enables precise differentiation between normal and cancerous cells. Furthermore, given the intrinsic basicity of histamine, pH-responsive CDs are advantageous for additional colorimetric and fluorescent monitoring of histamine in food freshness, achieving linearities of 25-1000 µM and 30-1000 µM, respectively, which are broader than those of alternative nanoprobes. Interestingly, the smartphone-integrated sensing platform can portably and visually evaluate pH and histamine changes due to sensitive color changes. Therefore, the sensor not only establishes a dynamic connection between pH and histamine for the purposes of biological and food monitoring, but also presents a novel approach for developing a multifunctional biosensor that can accomplish environmental monitoring and biosensing simultaneously.

Hybridizing Ti3C2Tx Layers with Layered Double Hydroxide Nanosheets at the Molecular Level: A Smart Electrode Material for H2O2 Monitoring in Cancer Cells.

Vertically stacked artificial 2D superlattice hybrids fabricated through molecular-level hybridization in a controlled fashion play a vital role in scientific and technological fields, but developing an alternate assembly of 2D atomic layers with strong electrostatic interactions could be much more challenging. In this study, we have constructed an alternately stacked self-assembled superlattice composite through integration of CuMgAl layered double hydroxide (LDH) nanosheets having positive charge with negatively charged Ti3C2Tx layers using well-controlled liquid-phase co-feeding protocol and electrostatic attraction and investigated its electrochemical performance in sensing early cancer biomarkers, i.e., hydrogen peroxide (H2O2). The molecular-level CuMgAl LDH/Ti3C2Tx superlattice self-assembly possesses superb conductivity and electrocatalytic properties, which are significant for obtaining a high electrochemical sensing aptitude. Electron penetration in Ti3C2Tx layers and rapid ion diffusion along 2D galleries have shortened the diffusion path and enhanced the charge transferring efficacy. The electrode modified with the CuMgAl LDH/Ti3C2Tx superlattice has demonstrated admirable electrocatalytic abilities in H2O2 detection with a wide linear concentration range and low real-time limit of detection (LOD) of 0.1 nM with signal/noise ratio (S/N) = 3. Practically, an electrochemical sensing podium based on the CuMgAl LDH/Ti3C2Tx superlattice has been effectively applied in real-time in vitro tracking of H2O2 effluxes excreted from different live cancer cells and normal cells after being encouraged by stimulation. The results exhibit that molecular-level heteroassembly holds great potential in electrochemical sensors to detect promising biomarkers.

The Impact of Short Intensive Care Rotation on Residents' Experience in the COVID-19 Pandemic: A Mixed-Methods Study.

Objectives: To assess the impact and utility of an intensive care unit (ICU) rotation during the coronavirus disease 2019 (COVID-19) pandemic and the need for mandatory ICU rotations in training for all clinical specialties. Methods: A mixed methods study was conducted from January to September 2021 at the Aga Khan University Hospital, including resident doctors who rotated through COVID ICU between May and September 2020. An online survey was undertaken, followed by two focused group discussions (FGDs). Results: Fifty-nine complete responses out of a total of 86 were analyzed. Around 42.3% (n = 25) of doctors belonged to medicine/allied specialties and 57.6% (n = 34) had previous ICU experience. Both groups, with and without prior ICU experience, found the rotation equally challenging (82.3% (n = 28) versus 84% (n = 21), P = .776) and gained similar practical skills (35.3% (n = 12) versus 16% (n = 4), P = .072), however, those with experience gained significantly more knowledge (58.5% (n = 20) versus 32% (n = 8), P = .047). On opinion regarding mandatory ICU rotation, the majority agreed to have a mandatory rotation (82% (n = 28) versus 72% (n = 18), P = .421)) with an optimal duration of 1 to 2 months. The FGDs found that all residents encouraged the idea of mandatory training in ICU which must be tailored to their training specialty and suggested extending the duration beyond 1 week to ensure learning. Conclusions: COVID ICU rotation was a good avenue for learning and the idea of mandatory ICU training was supported. Mandating ICU rotation might theoretically enhance response to emergencies. More research is needed to understand for feasible incorporation of ICU training in the curriculum.