Effects of an instructional WhatsApp group on self-care and HbA1c among female patients with Type 2 diabetes mellitus.

AIMS AND OBJECTIVES: To assess the effect of an instructional WhatsApp group on self-care and HbA1c levels among female patients with type 2 diabetes mellitus (T2DM). BACKGROUND: T2DM is a chronic disease that requires effective self-care. WhatsApp is a free application that can be effectively used for patient education. DESIGN: This study used a quasi-experimental design. METHODS: A convenience sample of 62 female participants was recruited from the medical outpatient clinic of a tertiary hospital. The Diabetes Self-Care Scale was used to assess the self-care profiles of the participants pre- and post-intervention. HbA1c samples were also collected at baseline and three months after receiving instructions from the WhatsApp group. Sociodemographic and clinical data were collected during the pre-intervention stage. RESULTS: The mean HbA1c level decreased from 8.61 ± 1.70 to 7.92 ± 1.60 after implementing the WhatsApp group instructions; the values showed a significant difference (t-value = 5.107 and P-value < 0.001). The post-test mean score of total self-care was higher than the pre-test mean score (t-value = 12.359, P-value <0.001), indicating a highly significant difference. CONCLUSIONS: The study demonstrated that the instructional WhatsApp group is an effective method for improving self-care and HbA1c levels in patients with T2DM. This study suggests the use of WhatsApp group instructions as a teaching method in the healthcare system for the education and follow-up of patients with T2DM. RELEVANCE TO CLINICAL PRACTICE: The findings support the need to initiate effective and dynamic interventional follow-ups through WhatsApp groups for patients with T2DM to improve their self-care and HbA1c levels and ultimately reduce the burden on hospitals and governments.

Orange peel magnetic activated carbon for removal of acid orange 7 dye from water.

Magnetic activated carbon resources with a remarkably high specific surface area have been successfully synthesized using orange peels as the precursor and ZnCl2 as the activating agent. The impregnation ratio was set at 0.5, while the pyrolysis temperature spanned from 700 to 900 °C. This comprehensive study delved into the influence of activation temperatures on the resultant pore morphology and specific surface area. Optimal conditions were discerned, leading to a magnetic activated carbon material exhibiting an impressive specific surface area at 700 °C. The Brunauer-Emmett-Teller surface area reached 155.09 m2/g, accompanied by a total pore volume of 0.1768 cm3/g, and a mean pore diameter of 4.5604 nm. The material displayed noteworthy properties, with saturation magnetization (Ms) reaching 17.28 emu/g, remanence (Mr) at 0.29 emu/g, and coercivity (Hc) of 13.71 G. Additionally, the composite demonstrated super-paramagnetic behaviour at room temperature, facilitating its rapid collection within 5 s through an external magnetic field. Factors such as absorbent dose, initial concentration of the adsorbate, contact time, and pH were systematically examined. The adsorption behaviour for acid orange 7 (AO7) was found to adhere to the Temkin isotherm models (R2 = 0.997). The Langmuir isotherm model suggested a monolayer adsorption, and the calculated maximum monolayer capacity (Qm) was 357.14 mg/g, derived from the linear solvation of the Langmuir model using 0.75 g/L as an adsorbent dose and 150-500 mg/L as AO7 dye concentrations. The pseudo-second order model proved to be the best fit for the experimental data of AO7 dye adsorption, with a high coefficient of determination (R2) ranging from 0.999 to 1.000, outperforming other kinetic models.

Identification of cyclooxygenase-II inhibitory saponins from fenugreek wastes: Insights from liquid chromatography-tandem mass spectrometry metabolomics, molecular networking, and molecular docking.

INTRODUCTION: This research explores sustainable applications for waste generated from fenugreek (Trigonella foenum-graecum), a plant with both nutritional and medicinal uses. The study specifically targets waste components as potential sources of nutrients and bioactive compounds. OBJECTIVES: The focus is to conduct detailed metabolic profiling of fenugreek waste, assess its anti-inflammatory properties by studying its cyclooxygenase (COX) inhibitory effect, and correlate this effect to the metabolite fingerprint. MATERIALS AND METHODS: Ethanolic extracts of fenugreek fruit pericarp and a combination of leaves and stems were subjected to untargeted metabolic profiling using liquid chromatography-mass spectrometry integrated with online database searches and molecular networking as an effective dereplication strategy. The study also scrutinized the COX inhibitory capabilities of these extracts and saponin-rich fractions prepared therefrom. Molecular docking was employed to investigate the specific interactions between the identified saponins and COX enzymes. RESULTS: The analysis led to the annotation of 81 metabolites, among which saponins were predominant. The saponin-rich fraction of the fruit pericarp extract displayed the strongest COX-II inhibitory activity in the in vitro inhibition assay (IC50 value of 81.64 ± 3.98 µg/mL). The molecular docking study supported the selectivity of the identified saponins towards COX-II. The two major identified saponins, namely, proto-yamogenin 3-O-[deoxyhexosyl (1 → 2)] [hexosyl (1 → 4)] hexoside 26-O-hexoside and trigofenoside A, were predicted to have the highest affinity to the COX-II receptor site. CONCLUSION: In the present study, we focused on the identification of COX-II inhibitory saponins in fenugreek waste through an integrated approach. The findings offer valuable insights into potential anti-inflammatory and cancer chemoprotective applications of fenugreek waste.

Enhancing paracellular and transcellular permeability using nanotechnological approaches for the treatment of brain and retinal diseases.

Paracellular permeability across epithelial and endothelial cells is, in large part, regulated by apical intercellular junctions also referred to as tight junctions (TJs). These junctions contribute to the spatial definition of different tissue compartments within organisms, separating them from the outside world as well as from inner compartments, with their primary physiological role of maintaining tissue homeostasis. TJs restrict the free, passive diffusion of ions and hydrophilic small molecules through paracellular clefts and are important for appropriate cell polarization and transporter protein localisation, supporting the controlled transcellular diffusion of smaller and larger hydrophilic as well as hydrophobic substances. This traditional diffusion barrier concept of TJs has been challenged lately, owing to a better understanding of the components that are associated with TJs. It is now well-established that mutations in TJ proteins are associated with a range of human diseases and that a change in the membrane fluidity of neighbouring cells can open possibilities for therapeutics to cross intercellular junctions. Nanotechnological approaches, exploiting ultrasound or hyperosmotic agents and permeation enhancers, are the paradigm for achieving enhanced paracellular diffusion. The other widely used transport route of drugs is via transcellular transport, allowing the passage of a variety of pro-drugs and nanoparticle-encapsulated drugs via different mechanisms based on receptors and others. For a long time, there was an expectation that lipidic nanocarriers and polymeric nanostructures could revolutionize the field for the delivery of RNA and protein-based therapeutics across different biological barriers equipped with TJs (e.g., blood-brain barrier (BBB), retina-blood barrier (RBB), corneal TJs, etc.). However, only a limited increase in therapeutic efficiency has been reported for most systems until now. The purpose of this review is to explore the reasons behind the current failures and to examine the emergence of synthetic and cell-derived nanomaterials and nanotechnological approaches as potential game-changers in enhancing drug delivery to target locations both at and across TJs using innovative concepts. Specifically, we will focus on recent advancements in various nanotechnological strategies enabling the bypassing or temporally opening of TJs to the brain and to the retina, and discuss their advantages and limitations.

The Effects of Zirconium and Yttrium Addition on the Microstructure and Hardness of AlCuMgMn Alloy when Applying In Situ Heating during the Laser Melting Process.

This paper studies the effect of the laser melting process (LMP) on the microstructure and hardness of a new modified AlCuMgMn alloy with zirconium (Zr) and Yttrium (Y) elements. Homogenized (480 °C/8 h) alloys were laser-surface-treated at room temperature and a heating platform with in situ heating conditions was used in order to control the formed microstructure by decreasing the solidification rate in the laser-melted zone (LMZ). Modifying the AlCuMgMn alloy with 0.4 wt% Zr and 0.6 wt% Y led to a decrease in grain size by 25% with a uniform grain size distribution in the as-cast state due to the formation of Al3(Y, Zr). The homogenization dissolved the nonequilibrium intermetallic phases into the (Al) matrix and spheroidized and fragmentized the equilibrium phase's particles, which led to the solidification of the crack-free LM zone with a nonuniform grain structure. The microstructure in the LMZ was improved by using the in situ heating approach, which decreased the temperature gradient between the BM and the melt pool. Two different microstructures were observed: ultrafine grains at the boundaries of the melted pool due to the extremely high concentration of optimally sized Al3(Y, Zr) and fine equiaxed grains at the center of the LMZ. The combination of the presence of ZrY and applying a heating platform during the LMP increased the hardness of the LMZ by 1.14 times more than the hardness of the LMZ of the cast AlCuMgMn alloy.

Orange peels magnetic activate carbon (MG-OPAC) composite formation for toxic chromium absorption from wastewater.

This work prepared a composite of orange peels magnetic activated carbon (MG-OPAC). The prepared composite was categorized by X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), Brunauer-Emmett-Teller (BET), Energy-dispersive X-ray spectroscopy (EDX), Scanning Electron Microscopy (SEM) and vibrating-sample magnetometer (VSM) analyses. The MG-OPAC composite showed the surface area (155.09 m2/g), the total volume of pores (0.1768 cm3/g), and the mean diameter of pores (4.5604 nm). The saturation magnetization (Ms = 17.283 emu/g), remanence (Mr = 0.28999 emu/g) and coercivity (Hc = 13.714 G) were reported for the prepared MG-OPAC. Likewise, at room temperature, the MG-OPAC was in a super-paramagnetic state, which could be collected within 5 S (< 5 S) with an outside magnetic field. Influence of time of contact, absorbent dose, starting concentration of Cr6+ ions, and pH were tested to adjust the absorption process. The absorption behavior of MG-OPAC for hexavalent chromium was investigated by Langmuir (LIM), Freundlich (FIM) and Temkin (TIM) isotherm models (IMs). Applicability of LIM specifies that Cr6+ ions absorption procedure may be monolayer absorption. The maximum monolayer capacity (Qm) premeditated by LIM was 277.8 mg/g. Similarly, the absorption process was tested with different kinetic models like intraparticle diffusion (IPDM), pseudo-first-order (PFOM), Elovich (EM), pseudo-second-order (PSOM), and Film diffusion (FDM). The PSOM was best fitted to the experimental results of Cr6+ ions absorption with R2 ranging between 0.992 and 1.

Stressors and Coping Strategies among Nursing Students during the COVID-19 Pandemic: Scoping Review.

COVID-19 has impacted every aspect of life around the world. Nursing education has moved classes online. Undoubtedly, the period has been stressful for nursing students. The scoping review aimed to explore the relevant evidence related to stressors and coping strategies among nursing students during the COVID-19 pandemic. The scoping review methodology was used to map the relevant evidence and synthesize the findings by framing the research question using PICOT, determining the keywords, eligibility criteria, searching the CINAHL, MEDLINE, and PubMed databases for the relevant studies. The review further involved study selection based on the PRISMA flow diagram, charting the data, collecting, and summarizing the findings. The critical analysis of findings from the 13 journal articles showed that the COVID-19 period has been stressful for nursing students with classes moving online. The nursing students feared the COVID-19 virus along with experiencing anxiety and stressful situations due to distance learning, clinical training, assignments, and educational workloads. Nursing students applied coping strategies of seeking information and consultation, staying optimistic, and transference. The pandemic affected the psychological health of learners as they adjusted to the new learning structure. Future studies should deliberate on mental issues and solutions facing nursing students during the COVID-19 pandemic.

Influence of Adding Modifying Elements and Homogenization Annealing on Laser Melting Process of the Modified AlZnMgCu with 4%Si Alloys.

AlZnMgCu, the high-strength aluminum alloy, is unsuitable for laser melting applications due to its high hot cracking sensitivity and large solidification temperature range. Adapting this alloy for laser melting processing is a high-demand research issue for extending its use. Thus, this paper investigates the effect of adding 4%Si, 4%Si-Sc+Zr, 4%Si-Ti+B, and homogenization annealing on the laser melting process (LMP) of AlZnMgCu alloy. Homogenization annealing at 500 °C for 6.5 h was selected to dissolve most of the low melting temperature phases into the grain matrix and perform stable alloys for the LMP. The pulsed laser melting process (PLM) was performed on the as-casted and the homogenized samples. The microstructures of the as-casted, the homogenized alloys, and after the LMP were evaluated. In addition, the hardness of the base metal (BM) and laser melted zone (LMZ) were measured. The results revealed that the microstructure was enhanced and refined in the as-cast state by adding the modifiers due to the increasing nucleation potency of solidification sites and the formation of primary Al3(Ti, Zr, Sc) phases. The average grain size was decreased by 15.6 times when adding 4%Si + 0.4%Zr + 0.29%Sc, while it decreased by 10.2 times when adding 4%Si + 1%Ti + 0.2%B. The LMZ of the as-casted samples exhibited a non-uniform distribution of the grains and the elements after the LMP. This was attributed to the evaporation of Zn, Mg during the high laser power process besides the non-uniform distribution of elements and phases in samples during casting. After the laser treating of the homogenized samples with 4%Si-Sc + Zr, uniform columnar grains were formed in the direction of the laser. The presence of Ti and B changed the crystallization nature, resulting in the LMZ with very fine and equiaxed grains due to forming many nucleation centers during solidification. The hardness values have positively increased due to Si addition and adding a combination of Ti + B and Sc + Zr. The maximum hardness was 153.9 ± 5 HV achieved in the LMZ of the homogenized samples of 4%Si + 1%Ti + 0.2%B.

Levonorgestrel vs combined oral contraceptive pills in treatment of female acne and hirsutism.

Combined oral contraception was used in many studies for treatment of acne and hirsutism. However, levonorgestrel (LNG) alone has not been evaluated before. Our objective is to evaluate the efficacy of oral contraceptive (OC) pills containing LNG and ethinyl estradiol (EE) compared with LNG only for the treatment of acne and hirsutism in a randomized, controlled prospective clinical trial. Eighty females (20 with acne, 20 with hirsutism, and 40 healthy females) received LNG + EE or LNG only for 6 months. Assessment of acne by global acne grading system (GAGS) and hirsutism by modified Ferriman-Gallwey scale (MFGS) grading system and serum free testosterone was measured before and 6 months after treatment. Serum free testosterone was significantly higher before treatment in acne and hirsutism patients compared to control group (P < .000). In acne patients, after 6 months of treatment with LNG/EE, serum free testosterone, and (GAGS), were significantly decreased compared to LNG only (P < .000). In hirsutism group, after 6 months of treatment with LNG/EE, serum free testosterone and (MFGS), were nonsignificantly decreased compared to LNG only. OCs containing either LNG/EE or LNG seem to be effective and safe treatment for acne and hirsutism.

Tobacco cigarette smoking exacerbates aortic calcification in an early stage of myocardial infarction in a female mouse model.

Despite increased social awareness, marketing restraints, tobacco taxation, and available smoking cessation rehab programs, active and passive smoking remain a worldwide challenging epidemic and a key risk factor for cardiovascular diseases development. Although cardiovascular (CV) protection is more pronounced in women than in men due to estrogenic effects, tobacco cigarette smoking exposure seems to alter this protection by modulating estrogen actions via undefined mechanisms. Premenopausal cigarette smoking women are at higher risk of adverse CV effects than non-smokers. In this study, we investigated the impact of cigarette smoking on early CV injury after myocardial infarction (MI) in non-menopausal female mice. Aortic arch calcification, fibrosis, reactive oxygen species, and gene expression of inflammatory and calcification genes were exaggerated in mice exposed to cigarette smoke (CS). These findings suggest that aortic injury following MI, characterized by vascular smooth muscle cells transdifferentiation, calcification, inflammation, and collagen deposition but not cardiac dysfunction is exacerbated with CS exposure. The novel findings of this study highlight the importance of aortic injury on short and long-term prognosis in CS-exposed MI females. Linking those findings to estrogen alteration is probable and entails investigation.

Evaluation of the Microstructure and Mechanical Properties of a New Modified Cast and Laser-Melted AA7075 Alloy.

The mechanical properties and microstructure of as-cast and homogenized AA7075 were investigated. This alloy was modified by adding transition elements 0.3%Sc + 0.5%Zr, 1%Ti + 0.2%B, and 1%Fe + 1%Ni for use in additive manufacturing applications. After adding Ti + B and Sc + Zr, the structure became uniform and finer with the formation of the Al3(Sc, Zr) and TiB2 phases. Coarse structures were obtained with the formation of an extremely unfavorable morphology, close to a needle-like structure when Fe + Ni was added. The mechanical properties of the modified alloys were increased compared to those of the standard alloy, where the best ultimate tensile strength (UTS) and yield strength (YS) were obtained in the AA7075-TiB alloy compared to the standard alloy in as-cast and homogenized conditions, and the highest hardness value was provided by Fe + Ni additives. The effect of the laser melting process on the microstructure and mechanical properties was investigated. Single laser melts were performed on these alloys using 330 V and a scanning speed of 8 mm/s. During the laser melting, the liquation of the alloying elements occurred due to non-equilibrium solidification. A change in the microstructures was observed within the melt zone and heat-affected zone (HAZ). The hardness of the laser-melted zone (LMZ) after adding the modification elements was increased in comparison with that of the standard alloy. Corrosion testing was performed using a solution of 100 mL distilled water, 3.1 g NaCl, and 1 mL HCl over 5, 10, and 30 min and 1 and 2 h. The corrosion resistance of the alloy modified with FeNi was low because of the non-uniform elemental distribution along the LMZ, but in the case of modification with ScZr and TiB, the corrosion resistance was better compared to that of the standard alloy.

Ultrasound-Guided Serratus Anterior Plane Block Versus Thoracic Epidural Analgesia for Thoracotomy Pain.

OBJECTIVE: Thoracotomy is one of the most painful surgical procedures. The aim of this study was to assess the efficacy and safety of ultrasound-guided serratus anterior plane block (SAPB) compared with thoracic epidural analgesia (TEA) for controlling acute thoracotomy pain. DESIGN: A prospective, randomized, observer-blinded, controlled study. SETTING: The study was performed as a single-institution study in the National Cancer Institute, Cairo University, Egypt. PARTICIPANTS: All participants were cancer patients scheduled for thoracotomy. INTERVENTIONS: This study was conducted from February to December 2015. Forty patients scheduled for thoracotomy under general anesthesia were allocated randomly into 1 of 2 groups with 20 patients each. SAPB was performed before extubation with an injection of 30 mL of 0.25% levobupivacaine followed by 5 mL/hour of 0.125% levobupivacaine. In the TEA group, thoracic epidural catheters were inserted preoperatively to be activated before extubation using a lower dose regimen to the SAPB group. Heart rate, mean arterial pressure, and the visual analog pain score (VAS) measurements were recorded for 24 hours. Rescue analgesia using intravenous morphine, 0.1 mL/kg, was administered if the VAS was >3. MEASUREMENTS AND MAIN RESULTS: Compared with preoperative values, the mean arterial pressure in the SAPB group did not change significantly (p = 0.181), whereas it decreased significantly (p = 0.006) in the TEA group. VAS scores and the total dose of morphine consumed were comparable in the 2 groups. CONCLUSIONS: SAPB appeared to be a safe and effective alternative for postoperative analgesia after thoracotomy.