Simultaneous multidimensional impacts of active learning revealed in a first implementation in the MENA region.

Enhancing science education in developing countries has been a focal point of many studies and efforts, but reform has mainly been driven by top-down approaches that often face impediments. A shift to active learning pedagogies can potentially address these challenges, but it has thus far been predominantly implemented and understood in developed countries. Thanks to the growing accessibility of open education resources and ubiquitous technologies, education reform can now be carried out from the bottom up. Here, we present the results of a two-year implementation of active learning in five core physics and astronomy courses comprising 2,145 students from the Middle East and North Africa (MENA) region. Simultaneous improvements are observed in both students' performance and their perception of the quality of learning; means improved by 9% (0.5 SD) and 25% (1.5 SD), respectively. The performance gap between students in the bottom quartile and those in the top quartiles was narrowed by 17%. The failure rate was reduced to a third of that in traditional classes; this is 36% better than the results in developed countries, indicating a greater need for active pedagogies by MENA students. Our findings reveal a multidimensional positive influence of active learning, the viability of its grassroots implementation with open resources, and its sustainability and reproducibility. We suggest that wider implementation can boost education-driven economic growth by 1% in per capita gross domestic product [GDP], substantially cut costs of repeating courses, and produce a more competent STEM workforce-all of which are urgently needed to stimulate development and growth.

Utility of a virtual small group cognitive behaviour program for autistic children during the pandemic: evidence from a community-based implementation study.

BACKGROUND: Autistic children often experience socioemotional difficulties relating to emotion regulation and mental health problems. Supports for autistic children involve the use of adapted interventions that target emotion regulation and social skills, alongside mental health symptoms. The Secret Agent Society Small Group (SAS: SG), an adapted cognitive behavioural program, has demonstrated efficacy through lab-delivered randomized control trials. However, research is still needed on its effectiveness when delivered by publicly funded, community-based autism providers under real-world ecologically valid conditions, especially within the context of a pandemic. The COVID-19 pandemic has disrupted access to community-based supports and services for autistic children, and programs have adapted their services to online platforms. However, questions remain about the feasibility and clinical utility of evidence-based interventions and services delivered virtually in community-based settings. METHODS: The 9-week SAS: SG program was delivered virtually by seven community-based autism service providers during 2020-2021. The program included the use of computer-based games, role-playing tasks, and home missions. Caregivers completed surveys at three timepoints: pre-, post-intervention, and after a 3-month follow-up session. Surveys assessed caregivers' perception of the program's acceptability and level of satisfaction, as well as their child's social and emotional regulation skills and related mental health challenges. RESULTS: A total of 77 caregivers (94% gender identity females; Mean = 42.1 years, SD = 6.5 years) and their children (79% gender identity males; Mean = 9.9 years, SD = 1.3 years) completed the SAS: SG program. Caregivers agreed that the program was acceptable (95%) and were highly satisfied (90%). Caregivers reported significant reduction in their child's emotion reactivity from pre- to post-intervention (-1.78 (95% CI, -3.20 to -0.29), p = 0.01, d = 0.36), that continued to decrease after the 3-month booster session (-1.75 (95% CI, -3.34 to -0.16), p = 0.02, d = 0.33). Similarly, improvements in anxiety symptoms were observed (3.05 (95% CI, 0.72 to 5.36), p = 0.006, d = 0.39). CONCLUSIONS: As online delivery of interventions for autistic children remains popular past the pandemic, our findings shed light on future considerations for community-based services, including therapists and agency leaders, on how best to tailor and optimally deliver virtually based programming. TRIAL REGISTRATION: This study has been registered with ISRCTN Registry (ISRCTN98068608) on 15/09/2023. The study was retroactively registered.

Exploring the use of clay pots as sustainable storage containers to improve water quality.

BACKGROUND: Currently, tap water consumption is not highly preferred in Egypt and around the world. People prefer to consume bottled water because they believe that it is much safer and tastes better than tap water. Unfortunately, this preference can create an economic burden for many people, especially in developing countries. Clay pots can be used to provide cool, alkaline drinking water because of their porous micro-texture, which traps pollutants. This study aimed to investigate the use of clay pots to store tap water and its impact on the requirements for drinking water quality. This is done with the intent to decrease the need for bottled water as a means of offering a more sustainable and economical option. METHODS: In this study, the efficiency of clay pots as sustainable storage containers for drinking water was tested by measuring physicochemical parameters (pH, TDS, EC, turbidity, DO, ammonia, chloride, total hardness, Ca hardness, Mg hardness, chlorine, Zn, and CaCO3) and biological parameters (TPC and Legionella). RESULTS: After 7 days of storage, the quality of the water stored in clay pots met the standards set by the Egyptian law with a significant difference (p < 0.05) before and after the storage of water It was found that the dissolved oxygen increased from 6.17 ppm to 7.52 ppm after 7 days. As for total hardness, it declined from 195 to 178 ppm. There was also a significant drop in terms of TDS from 338 to 275 ppm. Furthermore, clay pots effectively filtered out both total viable bacteria and Legionella. CONCLUSION: This study proved the efficiency of using these containers with respect to some indicator values for tap water and tank water analysis. Clay pots are an excellent, cost-effective, and sustainable alternative for storing water.

The Challenges of Caregivers of Children with Autism Spectrum Disorders Comorbidity during the COVID-19 Pandemic in Serbia.

BACKGROUND: Children with Autism Spectrum Disorders (ASD) experience significantly higher prevalence of other mental disorders, which amplifies their need for overall support. The outbreak of novel coronavirus (COVID-19) resulted in restrictions and limited access to different services with great challenge for families and children with ASD. SUBJECTS AND METHODS: We used an electronic SurveyMonkey questionnaire to examine the experiences of 114 caregivers of children with ASD. We compared: (a) level of support by the child's school, changes in child behavior, and priority needs for families of ASD and ASD with comorbidities (ASD+) children, during pandemic, and (b) developmental history and diagnosis for ASD and ASD+ children before the pandemic. RESULTS: Our research shows significant behavioral difficulties in the population with ASD and ASD+ that arose in the field of altered living conditions and overall functioning during the COVID-19 pandemic. Statistically significant results comparing ASD to ASD+ children we found in area of getting additional help and support before the outbreak of the pandemic (47.1% vs 16.0%, p=0.002), as well as in worsening of sleep problems, statistically significant more common in children with ASD+ (ASD+ 47.7% vs. ASD 25.7%, p=0.046). CONCLUSIONS: Our findings can contribute to the faster development and implementation of protocols for dealing with situations such as pandemics, related to the vulnerable population of children with ASD and their caregivers.

Candidate circulating microRNAs as potential diagnostic and predictive biomarkers for the monitoring of locally advanced breast cancer patients.

This study aimed at investigating the expression of candidate microRNAs (miRs), at initial diagnosis, during neoadjuvant chemotherapy, and after the tumor resection in locally advanced breast cancer patients. Plasma samples were collected from locally advanced breast cancer patients (n = 30) and healthy subjects (n = 20) for the detection of candidate miRs' expression using the real-time quantitative polymerase chain reaction. At initial locally advanced breast cancer diagnosis, the expression of miR-21, miR-181a, and miR-10b was significantly increased, whereas that of miR-145 and let-7a was significantly decreased, compared to the healthy individuals. The diagnostic accuracy of miR-21 was superior to both carcinoembryonic antigen and carcinoma antigen 15-3 as diagnostic biomarkers for locally advanced breast cancer. By the end of the treatment, the expression of altered miRs rebound to control values. The expression levels of candidate plasma miRs are useful diagnostic biomarkers, as well as monitoring a proper response for locally advanced breast cancer patients to the treatment. Furthermore, miR-10b and miR-21 can be considered as predictive biomarkers for progression-free survival.

Poor Outcome of Surgical Management of Acute Malfunctioning Mechanical Mitral Valve During Pregnancy. Should Centers with Limited Resources Find Different Options?

BACKGROUND: Rheumatic heart disease (RHD) is the most common cardiac disease in pregnancy in developing countries with the mitral valve being the most affected. In this study, the results of surgical intervention in pregnant women presented with acute malfunctioning mechanical mitral valve were discussed. METHODS: All patients underwent emergency redo mitral valve replacement due to acute malfunctioning mechanical mitral valve during pregnancy in a single center between January 2005 and December 2017. These patients were retrospectively analyzed. Additionally, anticoagulation strategy before the event and outcomes for the mother and the fetus were outlined. RESULTS: Between 2005 and 2017, 16 pregnant women arrived in a single tertiary center with acute malfunctioning mechanical mitral valves. The mean gestational age at the time of presentation was 13.19 ± 2.6 weeks. Fifteen out of the 16 patients changed their anticoagulation regimen either with or without medical advice. After replacing the valve, cardiopulmonary bypass successfully was weaned in 12 patients, who were transferred to the ICU sedated and ventilated with variable doses of chemical Inotropes. The remaining 4 patients died on the table after failure of weaning from bypass. In one case, the patient developed immediate postoperative stroke with the Glasgow Coma Scale (GCS) of 7, CT brain revealed massive infarction, her fetus was not viable, she remained sedated and ventilated, and she passed away on post-operative Day 12, due to pneumonia and sepsis. Another patient, with a viable fetus, passed away on post-operative Day 1, due to low cardiac output. CONCLUSION: Acute malfunctioning MHV during pregnancy represents a real dilemma to patients and caregivers. It carries high fetal and maternal morbidity and mortality, especially in centers with limited resources. We believe that an alternative plane must be formulated for such patients to avoid devastating complications, including maternal and fetal deaths.

Thromboembolic events in cancer patients on active treatment with cisplatin-based chemotherapy: another look!

BACKGROUND: The risk of thromboembolic events is higher among cancer patients, especially in patients undergoing chemotherapy. Cisplatin-based regimens claim to be associated with a very high thromboembolic rate. In this study, we report on our own experience with thrombosis among patients on active cisplatin-based chemotherapy. METHODS: Medical records and hospital databases were searched for all the patients treated with any cisplatin-based regimen for any kind of cancer. Thrombosis was considered cisplatin-related if diagnosed any time after the first dose and up to 4 weeks after the last. The Khorana risk assessment model was performed in all cases. RESULTS: A total of 1677 patients (65.5% males, median age: 50 years) treated with cisplatin-based regimens were identified. Head and neck (22.9%), lung (22.2%), lymphoma and gastric (11.4% each) were the most common primary tumors. Thromboembolic events were reported in 110 (6.6%); the highest was in patients with gastric cancer (20.9%) and the lowest in patients with head and neck cancers (2.3%) and lymphoma (1.6%). Thrombosis included deep vein thrombosis (DVT) in 69 (62.7%), pulmonary embolism (PE) in 18 (16.9%) and arterial thrombosis in 17 (15.6%). A majority (51.1%) of the patients had stage IV disease and only 16% had stage I or II.In a multivariate analysis, significantly higher rates of thrombosis were associated with gastric as the primary tumor, advanced-stage disease, female sex but not age, and the Khorana risk score or type of cisplatin regimen. While the presence of CVC was significantly associated with the risk of thrombosis (p < 0.0001) in the univariate analysis, and such significance was lost in the multivariate analysis (odds ratio, 1.098; 95%CI, 0.603-1.999, p = 0.7599). CONCLUSIONS: Thromboembolic events in cancer patients on active cisplatin-based chemotherapy were commonly encountered. Gastric cancer, regardless of other clinical variables, was associated with the highest risk.

The influence of aging on the association between adiposity and bone mineral density in Jordanian postmenopausal women.

The objective of this study was to assess the relative association between body weight, body mass index (BMI), lean mass (LM) and fat mass (FM), and bone mineral density (BMD) in a group of Jordanian postmenopausal women and investigate if this possible association changes with age. A total of 3256 patients had dual-energy X-ray absorptiometry (DXA) scan in the period from January 2009 till January 2012 at the Radiology and Nuclear Medicine Department of Jordan University Hospital. Only 584 women met the selection criteria. Age has been recorded, and patients were divided into subgroups according to age. Body weight and height were measured, and BMI was calculated. Body composition (LM, FM, percentage of android fat, and percentage of gynoid fat) was assessed by DXA. BMD of the lumbar spine (L1-L4) and femoral neck was measured by DXA. Weight, BMI, FM, LM, percentage of android fat, and percentage of gynoid fat were positively correlated to BMD at both lumbar spine and femoral neck. However, this correlation disappeared at the age of 70 yr at lumbar spine and 75 yr at femoral neck. This study suggests that both FM and LM are important determinants of BMD in Jordanian postmenopausal women, and this correlation disappears after the age of 70 yr at lumbar spine and 75 yr at femoral neck.

Coherence of Parental Representations Following Therapy for Autistic Children.

Autistic children experience high rates of mental health challenges, and links have been found between child mental health and the parent-child relationship. As parents of autistic children are often actively involved in their child's treatment, it is important to consider aspects of the parent-child relationship within this context. The present study investigated changes in a component of the parent-child relationship, the coherence of parental representations, following participation in a 10-week cognitive behavioural therapy intervention designed to address autistic children's mental health challenges. Relationships were examined between coherence and child characteristics (i.e., autism symptoms, mental health), and associations with child treatment outcomes (i.e., mental health). Participants included 81 children (89% boys) aged 8 to 13 years and their parents (85% mothers) aged 35 to 54 years. Baseline levels of coherence were related to children's mental health symptoms but not autism symptoms. Although there were no significant changes in overall coherence across therapy, subscale-level improvements (i.e., concern, acceptance) emerged. Changes in coherence across therapy were linked with children's post-intervention behavioural symptoms and were approaching significance for internalizing problems, but were not associated with externalizing problems. It is critical to investigate factors that shape the coherence of parents' representations of their children, as this may provide insight into potential targets for intervention. Ascertaining whether participation in therapy improves parental coherence, and consequently child treatment outcomes, can advocate for parent-involved therapy, which will ultimately benefit the well-being of autistic children.

Thoracic cavity of the Shirazi cats: New insights using computed tomography and magnetic resonance imaging.

Our study provided a comprehensive characterization of the thorax of Shirazi cats by comparing the relevant soft and bone windows of computed tomography (CT) and magnetic resonance imaging (MRI) with cross, sagittal and coronal sectional anatomy. We outlined the mediastinum and its anatomic relationships with the trachea, oesophagus, lungs, heart, cranial and caudal vena cavae, and other thoracic structures using the data series gathered from adult normal Shirazi cats. The cranial mediastinum extended from the thoracic inlet to the 4th intercostal space, the middle mediastinum extended from the 5th and 7th intercostal spaces and was occupied by the heart and large blood vessels and the caudal mediastinum extended as a short and narrow portion from the 8th intercostal space to the diaphragm. The contents of the mediastinum and its relationship with the lungs and diaphragm were clearly presented in coronal-sectional anatomy and CT slices. The diaphragm was clearly observed in the lung windows of the ventral thorax. Sagittal-sectional anatomy and CT clarified the thorax's architecture and its contents, with higher density in the soft windows. The distribution of thoracic vessels on cross- and coronal-contrast CT scans was clearly visible. In addition, MRI scans provided an excellent anatomic reference of the thorax with the help of cross, coronal and sagittal scans, especially in the heart and blood vessels. Our study provides a valuable atlas for the diagnosis of malformations of the thoracic structures and offers better assessments for helping veterinary radiologists and clinicians in diagnostic processes.

Evaluation of an adapted virtual training for master trainers of the WHO Caregiver Skills Training Program during the COVID-19 pandemic.

LAY ABSTRACT: The COVID-19 pandemic interrupted in-person professional activities. We developed and evaluated a remote training approach for master trainers of the Caregiver Skills Training Program. Master trainers support community practitioners, who in turn deliver the Caregiver Skills Training Program to caregivers of children with developmental delays or disabilities. The Caregiver Skills Training Program teaches caregivers how to use strategies to enhance learning and interactions during everyday play and home activities and routines with their child. The aim of this study was to evaluate the remote training of master trainers on Caregiver Skills Training Program. Twelve out of the 19 practitioners who enrolled in the training completed the study. The training consisted of a 5-day in-person session completed prior to the pandemic, followed by supporting participants' ability to identify Caregiver Skills Training Program strategies through coding of video recordings over 7 weekly meetings and group discussions and ended with participants independently coding a set of 10 videos for Caregiver Skills Training Program strategies. We found all but one participant was able to reliably identify Caregiver Skills Training Program strategies from video recordings despite a lack of ability to practice the Caregiver Skills Training Program strategies with children due to the pandemic. Taken together, our findings illustrate the feasibility and value of remote training approaches in implementing interventions.

Association of postural balance and isometric muscle strength in early- and middle-school-age boys.

OBJECTIVE: The purpose of this study was to evaluate the isometric muscle strength (IMS) and dynamic balance in early- and middle-school-age boys and to assess the strength of association between the dynamic balance scores and 6 different IMS indexes. METHODS: This is a cross-sectional study of a convenience sample of 94 boys who were 6 to 10 years of age and classified into an early school age (6-8 years) group (n = 50) and a middle school age (8-10 years) group (n = 44). Balance was tested using a Biodex Balance System. Anteroposterior Stability Index, Mediolateral Stability Index, and Overall Stability Index were recorded. IMS of 11 muscle groups was measured with a handheld dynamometer and categorized into 6 different muscle strength indices. RESULTS: The mean (SD) values of anteroposterior, mediolateral, and overall stability indexes observed for all study boys were 1.9 ± 1.0, 1.2 ± 0.7, and 2.5 ± 1.2 respectively. In the middle school age group, strong positive relationships were detected between the overall stability index and trunk, lower limb, anti-gravity, pro-gravity, and total strength indexes (r = -0.86/P < .001, r = -0.91/P < .001, r = -0.88/P < .001, r = -0.83/P < .001, and r = -0.84/P < .001 respectively), while no significant relationship was detected with the upper limb strength index (r = 0.159/P = .303). In the early school age group, moderate positive relationships were detected between the overall stability index and anti-gravity, lower limb, and total strength indexes (r = -0.404/P = .004, r = -0.356/P = .011, and r = -0.350/P = .013 respectively). CONCLUSION: Dynamic balance did not appear to be mature by the age of 10 years. Better balance skills were recorded in the mediolateral direction than in the anteroposterior direction. In the middle school age group, the overall stability index had positive relationships with almost all examined muscle strength indexes excepting the upper limb strength index.

Effectiveness of Partial Body Weight-Supported Treadmill Training on Various Outcomes in Different Contexts among Children and Adolescents with Cerebral Palsy: A Systematic Review and Meta-Analysis.

The efficiency of partial body weight-supported treadmill training (PBWSTT) for treating various conditions in children and adolescents with cerebral palsy (CP) in diverse contexts of rehabilitation, households, or schools is unknown. The major objective of this systematic review and meta-analysis was to analyze the effectiveness of PBWSTT on various outcomes in different contexts among children and adolescents with CP. We incorporated full-text, randomized controlled trial studies that specifically assessed the effects of PBWSTT walking, motor function, stride, balance, and endurance in children and adolescents aged 3 to 18 years with CP. The literature search was carried out using Google Scholar, PubMed, Web of Science, CINAHL Plus, Scopus, PEDro, and ResearchGate databases. The methodological quality was evaluated using a Cochrane risk of bias instrument. A meta-analysis of pooled data from 10 studies with 255 participants demonstrated that PBWSTT for 4-12 weeks in rehabilitation (mean difference [MD] = 1.94, 95% confidence interval [CI] = 1.40-2.48, p < 0.0001), at home or in a school context (MD = 13.5, 95% CI = 13.9-16.0, p < 0.0001), was significantly effective for treating various conditions in children and adolescents suffering with CP. The period of 4-12 weeks of PBWSTT in rehabilitation and at-home/school settings is effective on various outcomes in children or adolescents with CP.

Clinician Knowledge, Confidence, and Treatment Practices in Their Provision of Psychotherapy to Autistic Youth and Youth with ADHD.

Autistic youth have an increased risk of mental health problems. Despite the efficacy of various psychotherapeutic approaches for autistic youth, they often do not receive these interventions. Research is needed to identify patterns of effective treatment for autistic youth and whether they differ from those used for youth with other neurodevelopmental conditions (e.g., attention-deficit hyperactivity disorder; ADHD). We compared clinicians' (N = 557) knowledge, confidence and practices when treating autistic youth and youth with ADHD. Although ratings were moderately high overall and similar interventions were used for both groups, clinicians were significantly less knowledgeable and confident when supporting autistic clients compared to clients with ADHD. Thus, improving clinician perspectives may help facilitate treatment for autistic youth with mental health problems.

Layer-by-layer development of chitosan/alginate-based platelet-mimicking nanocapsules for augmenting doxorubicin cytotoxicity against breast cancer.

Breast carcinoma is considered one of the most invasive and life-threatening malignancies in females. Mastectomy, radiation therapy, hormone therapy and chemotherapy are the most common treatment choices for breast cancer. Doxorubicin (DOX) is one of the most regularly utilized medications in breast cancer protocols. However, DOX has showed numerous side effects including lethal cardiotoxicity. This study aims to fortify DOX cytotoxicity and lowering its side effects via its combining with the antidiabetic metformin (MET) as an adjuvant therapy, along with its effective delivery using natural platelet-rich plasma (PRP), and newly-developed PRP-mimicking nanocapsules (NCs). The PRP-mimicking NCs were fabricated via layer-by-layer (LBL) deposition of oppositely charged biodegradable and biocompatible chitosan (CS) and alginate (ALG) on a core of synthesized polystyrene nanoparticles (PS NPs) followed by removal of the PS core. Both natural PRP and PRP-mimicking NCs were loaded with DOX and MET adjuvant therapy, followed by their physicochemical characterizations including DLS, FTIR, DSC, and morphological evaluation using TEM. In-vitro drug release studies, cytotoxicity, apoptosis/necrosis, and cell cycle analysis were conducted using MCF-7 breast cancer cells. Also, an in-vivo assessment was carried out using EAC-bearing balb/c mice animal model to evaluate the effect of DOX/MET-loaded natural PRP and PRP-mimicked NCs on tumor weight, volume and growth biomarkers in addition to analyzing the immunohistopathology of the treated tissues. Results confirmed the development of CS/ALG-based PRP-mimicking NCs with a higher loading capacity of both drugs (DOX and MET) and smaller size (259.7 ± 19.3 nm) than natural PRP (489 ± 20.827 nm). Both in-vitro and in-vivo studies were in agreement and confirmed that MET synergized the anticancer activity of DOX against breast cancer. Besides, the developed LBL NCs successfully mimicked the PRP in improving the loaded drugs biological efficiency more than free drugs.

Serum IGF-1 to IGFBP-3 Molar Ratio: A Promising Diagnostic Tool for Growth Hormone Deficiency in Children.

BACKGROUND: The serum insulin-like growth factor-1 (IGF-1)/insulin-like growth factor binding protein-3 (IGFBP-3) ratio has various potential applications in growth hormone-related disorders. This study aimed to investigate the performance of the IGF-1/IGFBP-3 ratio, independently and in combination with serum IGF-1 and IGFBP-3, in the diagnosis of growth hormone deficiency (GHD) in children with short stature (SS). METHODS: A 7-year cross-sectional observational study was conducted on 235 children with SS. Participants with known disorders that may affect IGF-1 other than GHD were excluded. Participants were classified into GHD (n = 64) and non-GHD (n = 171) groups. GHD was defined as a slow growth rate (<25th percentile over 1 year) and suboptimal growth hormone (GH) response to 2 GH stimulation tests (peak GH < 6.25 ng/mL using the DiaSorin Liaison assay). The sensitivity and specificity of serum IGF-1, IGFBP-3, and IGF-1/IGFBP-3 molar ratio, independently and in various combinations, were determined. RESULTS: GHD was diagnosed in 27.2% of participants. Among all studied variables, a low serum IGF-1/IGFBP-3 ratio demonstrated the greatest sensitivity for GHD (87.5%), with a comparable specificity (83.0%). The combination of low serum IGF-1, IGFBP-3, and IGF-1/IGFBP-3 ratio demonstrated the greatest specificity for GHD (97.7%), whereas the combination of normal serum IGF-1, IGFBP-3, and IGF-1/IGFBP-3 ratio demonstrated the greatest specificity for a non-GHD cause of SS (100.0%). CONCLUSION: Our data suggest that the serum IGF-1/IGFBP-3 ratio is a useful marker for the diagnosis of GHD in children who do not have other disorders that may affect serum IGF-1 levels. Further large studies are needed to confirm the diagnostic utility of the serum IGF-1/IGFBP-3 ratio.

Development and Evaluation of Core-Shell Nanocarrier System for Enhancing the Cytotoxicity of Doxorubicin/Metformin Combination Against Breast Cancer Cell Line.

Breast cancer is the most invasive and life-threatening cancer in women. The treatment options are usually a combination of mastectomy, radiation therapy, hormonal therapy and chemotherapy. As a standard practice, doxorubicin (DOX) is one of the commonly used drugs for breast cancer treatment. However, DOX is known to have many harmful adverse effects including its cardiotoxicity. Hence, recent reports used metformin (MET), an anti-diabetic drug, as an adjuvant therapy to decrease the severity of DOX's adverse effects and to improve its ultimate therapeutic outcome. The current study is aimed at co-loading and enhancing the encapsulation efficiency of the hydrophilic DOX and MET in poly(lactic-co-glycolic acid) (PLGA) nanocapsules (NCs) with oil core for breast cancer treatment. The NCs were developed by single emulsification-solvent diffusion technique, and were optimized through using two types of oils, pluronics and PLGA (50:50) of different molecular weights followed by various physicochemical characterizations. The obtained DOX/MET-loaded NCs showed the size and polydispersity index (PDI) of 203.0 ± 3.4 nm and 0.081 ± 0.03, respectively with a surface charge of -2.15 ± 0.2 mV. The entrapment efficiency of DOX and MET were about 93.7% ± 2.9 and 70% ± 1.6, respectively. The developed PLGA core-shell NCs successfully sustained the DOX/MET release for more than 30 days. The in-vitro results showed a significant enhancement in DOX cytotoxic effect as well as a duplication in its apoptotic effect upon addition of MET for both free DOX/MET combination and DOX/MET-loaded PLGA NCs against MCF-7. Besides, flow cytometry demonstrated that the DOX/MET-loaded NCs possess their antitumor effect by preventing DNA replication and cell division. This study provides a promising facile, rapid and reproducible single emulsification-solvent diffusion technique for improving the encapsulation and release of hydrophilic drugs in nanocapsules for biomedical applications.

Global prevalence of autism: A systematic review update.

Prevalence estimates of autism are essential for informing public policy, raising awareness, and developing research priorities. Using a systematic review, we synthesized estimates of the prevalence of autism worldwide. We examined factors accounting for variability in estimates and critically reviewed evidence relevant for hypotheses about biological or social determinants (viz., biological sex, sociodemographic status, ethnicity/race, and nativity) potentially modifying prevalence estimates of autism. We performed the search in November 2021 within Medline for studies estimating autism prevalence, published since our last systematic review in 2012. Data were extracted by two independent researchers. Since 2012, 99 estimates from 71 studies were published indicating a global autism prevalence that ranges within and across regions, with a median prevalence of 100/10,000 (range: 1.09/10,000 to 436.0/10,000). The median male-to-female ratio was 4.2. The median percentage of autism cases with co-occurring intellectual disability was 33.0%. Estimates varied, likely reflecting complex and dynamic interactions between patterns of community awareness, service capacity, help seeking, and sociodemographic factors. A limitation of this review is that synthesizing methodological features precludes a quality appraisal of studies. Our findings reveal an increase in measured autism prevalence globally, reflecting the combined effects of multiple factors including the increase in community awareness and public health response globally, progress in case identification and definition, and an increase in community capacity. Hypotheses linking factors that increase the likelihood of developing autism with variations in prevalence will require research with large, representative samples and comparable autism diagnostic criteria and case-finding methods in diverse world regions over time. LAY SUMMARY: We reviewed studies of the prevalence of autism worldwide, considering the impact of geographic, ethnic, and socioeconomic factors on prevalence estimates. Approximately 1/100 children are diagnosed with autism spectrum disorder around the world. Prevalence estimates increased over time and varied greatly within and across sociodemographic groups. These findings reflect changes in the definition of autism and differences in the methodology and contexts of prevalence studies.

Advances in Cancer Diagnosis: Bio-Electrochemical and Biophysical Characterizations of Cancer Cells.

Cancer is a worldwide leading cause of death, and it is projected that newly diagnosed cases globally will reach 27.5 million each year by 2040. Cancers (malignant tumors), unlike benign tumors are characterized by structural and functional dedifferentiation (anaplasia), breaching of the basement membrane, spreading to adjacent tissues (invasiveness), and the capability to spread to distant sites (metastasis). In the cancer biology research field, understanding and characterizing cancer metastasis as well as features of cell death (apoptosis) is considered a technically challenging subject of study and clinically is very critical and necessary. Therefore, in addition to the cytochemical methods traditionally used, novel biophysical and bioelectrochemical techniques (e.g., cyclic voltammetry and electrochemical impedance spectroscopy), atomic force microscopy, and electron microscopic methods are increasingly being deployed to better understand these processes. Implementing those methods at the preclinical level enables the rapid screening of new anticancer drugs with understanding of their central mechanism for cancer therapy. In this review, principles and basic concepts of new techniques suggested for metastasis, and apoptosis examinations for research purposes are introduced, along with examples of each technique. From our recommendations, the privilege of combining the bio-electrochemical and biosensing techniques with the conventional cytochemical methods either for research or for biomedical diagnosis should be emphasized.

Open fracture dislocation of the calcaneocuboid and naviculocuneiform joints: A case report.

Combined fracture and dislocation of the calcaneocuboid (CC) and naviculocuneiform (NC) joints is a very rare injury; therefore, it is under-reported. We present a case of rare open fracture and dislocation of the CC and NC joints by discussing the diagnosis, evaluation, management and prognosis.