Assessment of Knowledge and Communication Regarding Complementary and Alternative Medicine Among Physicians in Madinah City.

INTRODUCTION: Despite the recognition of the importance of physician knowledge and physician-patient communication about the use of complementary and alternative medicine (CAM), few studies have explored this issue. Therefore, this study aims to assess physicians' knowledge and physician-patient communication regarding CAM. METHODS: A cross-sectional study was conducted among physicians working at governmental hospitals and primary healthcare centers in Madinah, Saudi Arabia. The data collection tool was a validated English language questionnaire distributed using social media platforms. The questionnaire included sections to assess physician knowledge and communication about CAM. RESULTS: Of the 373 completed questionnaires, around 151 (40.5%) of the respondents stated that they have a poor level of knowledge about CAM, and 272 (72.9%) need to gain additional knowledge to properly counsel patients on CAM. Medical journals were the main source of knowledge about CAM. There were 121 (32.4%) physicians who believed that <20% of their patients use some form of CAM, and 180 (48.3%) believed that <20% of their patients spontaneously reported their CAM use without prompting or direct questioning. Around 180 (48.3%) of physicians believed that they asked <20% of their patients about using CAM. Regarding barriers that limit communication with the patient about CAM, the highest percentage was insufficient knowledge about CAM (137, 36.7%). CONCLUSION: The study showed that a significant number of physicians lack the appropriate knowledge about CAM and most of them agreed to gain additional knowledge to properly counsel their patients. Further research is needed to evaluate physicians' knowledge about CAM using a more objective method.

Effects of immersing Japanese quail eggs in various doses of riboflavin on reproductive, growth performance traits, blood indices and economics.

This investigation aimed to evaluate the impact of immersion (IM) riboflavin treatment on the hatchability, production efficiency, and carcass characteristics of Japanese quail eggs. A total of 260 eggs of Japanese quail birds were used for hatching and were randomly divided into 4 treatments with 5 replicates (13 eggs/replicate) in a fully randomized design. Hatching eggs were immersed in riboflavin for 2 min before incubation. The experiment treatments were designed as follows: G1 control group with no treatment, G2 treated with 3 g/L vit. B2 (IM), G3 treated with 4 g/L vit. B2 (IM) and G4 were treated with 5 g/L vit. B2 (IM). After hatching, 128 Japanese quail chicks, aged 7 d, were randomly grouped into 4 treatment groups, with 32 birds in each group. When quails were given vitamin B2 via immersion, they demonstrated significant enhancements in live body weight, body weight gain, feed consumption, and feed conversion ratio at different stages compared to the control group. Compared to control and other groups, the carcass parameters of Japanese quails given a 4 g/L immersion solution showed a significant improvement (P < 0.05). Hatchability and fertility (%) were considerably raised by Vit.B2 treatments of 3, 4, and 5g; the group immersed in 5 g/L had the highest percentages compared to the other groups. Furthermore, treated chickens with all concentrations of vitamin B2 had significantly higher blood indices than the controls. During the exploratory phase (1-6 wk) of age, the highest returns were reported in G4 treated with 5g/L vit. B2 (IM). Treating Japanese quail eggs with different dosages of vitamin B2 by immersion may be recommended to improve their productive and reproductive performance, blood indices, carcass traits, and economic efficiency.

Radiographic assessment of the quality of post and core restorations performed by general dental practitioners in Saudi Arabia.

Background: Dentists utilize various techniques and materials for post and core restoration of endodontically treated teeth, which remains a noteworthy health concern and can be addressed through interdisciplinary strategies to enhance outcomes. Therefore, this study aimed to evaluate the technical quality of the residual gutta-percha (GP) and posts by analysing the periapical radiographs of endodontically restored teeth. Methods: A total of 594 periapical digital radiographs were evaluated for tooth type, post material, post shape, design, diameter, length, residual GP, GP length, GP tapering, GP homogeneity, and final restoration. Frequency distribution and cross-tabulation of the variables were performed. Results: Maxillary molars had the highest frequency of restorations, including posts, accounting for 27.4 %, followed by maxillary premolars (25.4 %) and maxillary anterior teeth (19.2 %). The prefabricated metallic posts were most commonly used (81.0 %), among these, 50.4 % were screwed posts. Tapered posts were the most commonly used (65.6 %). The percentage of posts with an acceptable length was 58.2 %. The most commonly used posts exhibited a width of one-third of the root diameter, accounting for 87.0 %. Suitable GP lengths were observed in 61.1 % of the restorations, and 62.8 % demonstrated adequate GP homogeneity. The findings of this study revealed that crown restoration accounted for 42.6 % of the studied sample. Conclusions: The technical quality of the remaining GP after restoration was comparable to that of previous epidemiological investigations. However, the technical quality of the post was deemed suboptimal.

Synergism of floated paperboard sludge cake /sewage sludge for maximizing biomethane yield and biochar recovery from digestate: A step towards circular economy.

Anaerobic digestion of floated paperboard sludge (PS) cake suffers from volatile fatty acids (VFAs) accumulation, nutrient unbalanced condition, and generation of digestate with a risk of secondary pollution. To overcome these drawbacks, sewage sludge (SS) was added to PS cake for biogas recovery improvement under a co-digestion process followed by the thermal treatment of solid fraction of digestate for biochar production. Batch experimental assays were conducted at different SS:PS mixing ratios of 70:30, 50:50, 30:70, and 20:80 (w/w), and their anaerobic co-digestion performances were compared to the mono-digestion systems at 35 ± 0.2 °C for 45 days. The highest methane yield (MY) of 241.68 ± 14.81 mL/g CODremoved was obtained at the optimum SS:PS ratio of 50:50 (w/w). This experimental condition was accompanied by protein, carbohydrate, and VFA conversion efficiencies of 47.3 ± 3.2%, 46.8 ± 3.2%, and 56.3 ± 3.8%, respectively. The synergistic effect of SS and PS cake encouraged the dominance of Bacteroidota (23.19%), Proteobacteria (49.65%), Patescibacteria (8.12%), and Acidovorax (12.60%) responsible for hydrolyzing the complex organic compounds and converting the VFAs into biomethane. Further, the solid fraction of digestate was subjected to thermal treatment at a temperature of 500 °C for 2.0 h, under an oxygen-limited condition. The obtained biochar had a yield of 0.48 g/g dry digestate, and its oxygen-to-carbon (O/C), carbon-to-nitrogen (C/N), and carbon-to-phosphorous (C/P) ratios were 0.55, 10.23, and 16.42, respectively. A combined anaerobic co-digestion/pyrolysis system (capacity 50 m3/d) was designed based on the COD mass balance experimental data and biogenic CO2 market price of 22 USD/ton. This project could earn profits from biogas (12,565 USD/yr), biochar (6641 USD/yr), carbon credit (8014 USD/yr), and COD shadow price (6932 USD/yr). The proposed project could maintain a payback period of 6.60 yr. However, further studies are required to determine the associated life cycle cost model that is useful to validate the batch experiment assumptions.

Does the marketing age impact growth performance, carcass traits, economic feasibility and hemato-biochemical properties of genetically-modified quails?

The meat of the quail is one of the most delicious types, as it is rich in minerals and vitamins, especially vitamin K, which is useful in treating nervous diseases. In the present investigation, based on their live body weight, 270 genetically-enhanced white quail chicks of mixed sex were randomly assigned to 3 groups, each with 90 chicks. The first group's birds were slaughtered at 28 d of age. The birds in the second group were slaughtered at 31 d, and the birds in the third group were slaughtered at 34 d. Results showed no significant difference between the various groups in the overall mortality rate index at the end of each fattening stage (P > 0.05). There were substantial variations (P ≤ 0.05) in the average live weight index between the first and both groups at each group's marketing age. With increasing marketing age, body weight increases. Quail chicks raised for 34 d received the lowest EPEF (28.90 points), followed by those raised for 31 d and 28 d, which received 33.37 and 37.32 points, respectively. The economic feasibility of the 3 groups, no significant differences in the profit index were observed at the age of 28 d. Compared to the marketing age of the other 2 groups, it was noted that the profit index decreased as the birds advanced in age. Delaying marketing to 31 d leads to a decrease in profit by 5.7%, and delaying marketing to 34 d reduces the profit index to 26.36% compared to marketing at 28 d. For blood hematology parameters, a significant increase in the studied indicators with the age of the birds was observed through the study of blood indicators. Still, it did not reach the significance level. It could be concluded that 28 d is the ideal marketing age for the enhanced white quails, as it yielded the highest economic return and the best performance.

Performance and economic efficiency of laying hens in response to adding zeolite to feed and litter.

This study investigated the effect of different levels of zeolite in laying hen (Silver Montazah) diet and litter on productive performance, egg quality criteria, and economics during the second stage of production (40-56 wk of age). An experiment with a 3 × 4 factorial design was performed to study the effects of four levels of zeolite (0, 10, 15, and 20 g/kg feed) in the diet and three levels of zeolite (0, 1.5, and 2 kg/m2) in the litter. Adding zeolite to diet and litter significantly improved final BW and BW change, egg number, egg weight, egg mass, laying rate, feed consumption (FC), and feed conversion ratio (FCR), as well as egg quality criteria when compared to the unsupplemented group. Additionally, adding zeolite at a level of 2 kg /m2 litter and 20 g/kg diet achieved the greatest enhancement in productive performance features. Therefore, it can be suggested that the greatest results were obtained in laying farms when zeolite was added as a litter addition and as a supplement to feed.

Assessment of modified chitosan composite in acidic reservoirs through pilot and field-scale simulation studies.

Chemical flooding through biopolymers acquires higher attention, especially in acidic reservoirs. This research focuses on the application of biopolymers in chemical flooding for enhanced oil recovery in acidic reservoirs, with a particular emphasis on modified chitosan. The modification process involved combining chitosan with vinyl/silane monomers via emulsion polymerization, followed by an assessment of its rheological behavior under simulated reservoir conditions, including salinity, temperature, pressure, and medium pH. Laboratory-scale flooding experiments were carried out using both the original and modified chitosan at conditions of 2200 psi, 135,000 ppm salinity, and 196° temperature. The study evaluated the impact of pressure on the rheological properties of both chitosan forms, finding that the modified composite was better suited to acidic environments, showing enhanced resistance to pressure effects with a significant increase in viscosity and an 11% improvement in oil recovery over the 5% achieved with the unmodified chitosan. Advanced modeling and simulation techniques, particularly using the tNavigator Simulator on the Bahariya formations in the Western Desert, were employed to further understand the polymer solution dynamics in reservoir contexts and to predict key petroleum engineering metrics. The simulation results underscored the effectiveness of the chitosan composite in increasing oil recovery rates, with the composite outperforming both its native counterpart and traditional water flooding, achieving a recovery factor of 48%, compared to 39% and 37% for native chitosan and water flooding, thereby demonstrating the potential benefits of chitosan composites in enhancing oil recovery operations.

Characterization and Cytotoxicity Assessment of Synthesized Palladium (II) Complex-Encapsulated Zinc Oxide Nanoparticles for Cancer Treatment.

The treatment of cancer often leads to a range of adverse effects. Encapsulating drugs can mitigate these effects and enhance drug efficacy by enabling a controlled release at the site of interest. This study details the successful synthesis of zinc oxide nanoparticles (ZnONPs) through the precipitation of Zn(NO3)2·6H2O with KOH. A Pd(II) complex drug was synthesized from a Schiff base ligand derived from 2-hydroxybenzohydrazide and (E)-1-(2-(p-tolyl)hydrazono)propan-2-one using potassium tetrachloropalladate(II). This complex was subsequently incorporated into ZnONPs. Characterization of the resulting compounds was performed using Transmission Electron Microscopy (TEM), Dynamic Light Scattering (DLS), Zeta Potential, Fourier Transform Infrared (FTIR) Spectroscopy, and UV-visible spectroscopy. TEM imaging revealed particle sizes of 160.69 ± 4.74 nm for ZnONPs and 185.28 ± 2.3 nm for the Pd(II) complex-encapsulated ZnONPs. The Zeta potential values were 6.53 mV for ZnONPs and 7.36 mV for Pd(II) complex-encapsulated ZnONPs. UV-visible spectroscopy showed an absorption peak at 360 nm for ZnONPs, while the Pd(II) complex-encapsulated ZnONPs exhibited a peak at 410 nm. FTIR analysis indicated the presence of the Pd(II) complex within the ZnONPs, as evidenced by a consistent Zn-O vibrational band at 832 cm-1 and a shift in another peak from 460 to 413 cm-1. Additionally, the detection of a C = N stretching vibration at 1548 cm-1 and a carbonyl stretch at 1626 cm-1 was observed. The Encapsulation Efficiency (E.E.) of the Pd(II) complex was 97.2%. A drug release experiment conducted at pH 7 showed a steady-state release pattern after 16 h, with a cumulative release of 44.3%. The cytotoxic effects of the Pd(II) complex and its encapsulated form in ZnONPs on the MCF-7 cell line were assessed via MTT test. The Pd(II) complex encapsulated within ZnONPs exhibited decreased toxicity relative to the unencapsulated drug, as evidenced by a higher IC50 value of 418.5 µg/ml. This suggests that the encapsulation facilitates a sustained release, which allows for targeted accumulation within cells. The elevated IC50 value indicates that the drug delivery system may be engineered to modulate the release of the drug in a more controlled manner, potentially resulting in a prolonged release profile rather than an immediate therapeutic impact.

The impact of poverty and socioeconomic status on brain, behaviour, and development: a unified framework.

In this article, we, for the first time, provide a comprehensive overview and unified framework of the impact of poverty and low socioeconomic status (SES) on the brain and behaviour. While there are many studies on the impact of low SES on the brain (including cortex, hippocampus, amygdala, and even neurotransmitters) and behaviours (including educational attainment, language development, development of psychopathological disorders), prior studies did not integrate behavioural, educational, and neural findings in one framework. Here, we argue that the impact of poverty and low SES on the brain and behaviour are interrelated. Specifically, based on prior studies, due to a lack of resources, poverty and low SES are associated with poor nutrition, high levels of stress in caregivers and their children, and exposure to socio-environmental hazards. These psychological and physical injuries impact the normal development of several brain areas and neurotransmitters. Impaired functioning of the amygdala can lead to the development of psychopathological disorders, while impaired hippocampus and cortex functions are associated with a delay in learning and language development as well as poor academic performance. This in turn perpetuates poverty in children, leading to a vicious cycle of poverty and psychological/physical impairments. In addition to providing economic aid to economically disadvantaged families, interventions should aim to tackle neural abnormalities caused by poverty and low SES in early childhood. Importantly, acknowledging brain abnormalities due to poverty in early childhood can help increase economic equity. In the current study, we provide a comprehensive list of future studies to help understand the impact of poverty on the brain.

Assessment of the root and canal morphology in the permanent dentition of Saudi Arabian population using cone beam computed and micro-computed tomography - a systematic review.

INTRODUCTION: Root canal treatment procedures require a thorough understanding of root and canal anatomy. The purpose of this systematic review was to examine the morphological differences of teeth root and their canals assessed using cone-beam computed and micro-computed tomography in Saudi Arabian population. METHODOLOGY: An electronic search was conducted in PubMed / Medline, Scopus, Google Scholar, and Web of Science databases until January 2023 to retrieve related studies. "Root canal morphology," "Saudi Arabia," "Micro-CT," and "cone-beam computed tomography" were used as keywords. A modified version of previously published risk of bias assessment tool was used to determine the quality assessment of included studies. RESULTS: The literature search revealed 47 studies that matched the criteria for inclusion, out of which 44 studies used cone beam computed tomography (CBCT) and three were micro-computed tomography (micro-CT) studies. According to the modified version of risk of bias assessment tool, the studies were categorized as low, moderate, and high risk of bias. A total of 47,612 samples were included which comprised of either maxillary teeth (5,412), or mandibular teeth (20,572), and mixed teeth (21,327). 265 samples were used in micro-CT studies while 47,347 teeth samples were used in CBCT studies. Among the CBCT studies, except for three, all the studies were retrospective studies. Frequently used imaging machine and software were 3D Accuitomo 170 and Morita's i-Dixel 3D imaging software respectively. Minimum and maximum voxel sizes were 75 and 300 µm, Vertucci's classification was mostly used to classify the root canal morphology of the teeth. The included micro-CT studies were in-vitro studies where SkyScan 1172 X-ray scanner was the imaging machine with pixel size ranging between 13.4 and 27.4 µm. Vertucci, Ahmed et al. and Pomeranz et al. classifications were applied to classify the root canal morphology. CONCLUSION: This systematic review revealed wide variations in root and canal morphology of Saudi population using high resolution imaging techniques. Clinicians should be aware of the common and unusual root and canal anatomy before commencing root canal treatment. Future micro-CT studies are needed to provide additional qualitative and quantitative data presentations.

Does tranexamic acid effectively minimise blood loss in cleft palate repair? A rigorous assessment through comprehensive systematic review and meta-analysis.

Cleft palate repair is a common reconstructive procedure that can involve significant blood loss. Tranexamic acid (TXA) has been proposed to minimise blood loss during various surgical procedures, but its effectiveness in cleft palate repair remains unclear. This systematic review and meta-analysis aimed to assess the effectiveness of TXA to reduce postoperative blood loss. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive search across multiple databases, including PubMed, Cochrane, and Web of Science, to identify relevant studies published up to September 2023. Only randomised controlled trials (RCTs) were included. Primary outcomes measured were total blood loss, transfusion rates, and postoperative complications. We identified four relevant RCTs, which included 275 cleft palate patients with a mean (range) age of 28.7 (6-65) months. The pooled analysis found no significant difference in duration of surgery (MD -18.40 minutes, p = 0.09), preoperative haemoglobin (MD 0.46 g/dl, p = 0.27), or postoperative haemoglobin (MD 0.07 g/dl, p = 0.86) between TXA and control groups. Intraoperative blood loss was lower with TXA, but with TXA, the difference was not statistically significant (MD -16.63 ml, p = 0.15). TXA significantly improved surgical field visibility (p = 0.004). No adverse events occurred with its use. While no significant differences were found in surgical outcomes with TXA, surgical field visibility significantly improved, and TXA showed a promising safety profile. Larger and higher-quality RCTs are still needed to validate these preliminary findings before TXA can be considered as a standard treatment.

Anthropogenic-induced environmental and ecological changes in the Nile Delta over the past half-century.

Anthropogenic activities over the past half-century have had a negative impact on the wetland ecosystem in the Nile Delta, which provides essential provisioning and regulating services. Therefore, it is crucial to systematically investigate pollution levels and their ecological consequences at both spatial and temporal scales in order to promote sustainable development. In this study, data on metal pollution in the Manzala Lake were compiled through a systematic review of all published literature from 1968 to 2020. Additionally, agricultural data (including land use, pesticide and fertilizer usage, and discharge) and economic data for the same time period were collected to identify the main drivers of pollution. The results indicated an overall increasing trend in heavy metal concentrations during the study period. The average concentrations of metals, arranged in descending order, were as follows: Fe (15,115.5 µg/g) > Mn (722 µg/g) > Zn (115.4 µg/g) > Cu (65.9 µg/g) > Ni (62.5 µg/g) > Cr (58.1 µg/g) > Pb (54.1 µg/g) > Cd (4.7 µg/g) > Hg (0.1 µg/g). A linear regression model revealed that wastewater discharge, water reuse, and the use of pesticides and fertilizers are the main sources of heavy metal pollution in the Manzala Lake. Consequently, there has been a dramatic decrease in the biodiversity of fish and molluscan communities. The study also found a correlation between heavy metal pollution and socio-economic development, highlighting the urgent need for attention to the conservation, management, and sustainable development of the lake.

Radiographic Assessment of 121 Glass Fiber Post Procedures in 32 Patients Aged 21-60 Years Performed by 6th-Year Dental Students During the 2022-2023 Academic Year at the College of Dentistry, Jazan University, Saudi Arabia.

BACKGROUND The restoration of endodontically treated teeth (ETT) and severely damaged teeth has been a concern of clinicians. Glass Fiber Post (GFPs) combine the strength of carbon fiber posts with the esthetic appearance of glass to resemble natural dentin during dental restoration procedures. This radiographical study assessed the GFP carried out by students enrolled in the Clinical Comprehensive Course at the College of Dentistry, Jazan University. MATERIAL AND METHODS A total of 32 patients treated by 18 6th-year dental students with 121 GFPs were assessed in this cross-sectional radiographic study. The assessment covered tooth type, arch, post-to-root width, length of post in relation to the crown and root lengths, amount of remaining gutta percha (GP), and gap between GP and post. Data were analyzed using SPSS, and associations between variables were determined using the chi-square test. RESULTS Maxillary teeth were the most frequently restored with posts (88.4%) with most being (58.7%) anterior teeth, and 50.4% of posts had widths that were one-third that of the root. The percentage of posts was twice (71.1%) or equal to (26.4%) the crown length, whereas two-thirds of the tested GFPs were >5 mm of the remaining GP. Significant differences were observed in location and position of teeth with post width, post length in relation to crown or root length, and amount of remaining GP, with P values of 0.018, 0.000, and 0.001, respectively. CONCLUSIONS The assessed radiographs revealed that the performance of sixth year students in accomplishment GFP radiographically was satisfactory and within the values recommended in the literature.

Assessment of the quality of root canal fillings performed on extracted teeth by undergraduate dental students in a sample from Saudi Arabia.

BACKGROUND: The educational process in the field of endodontics commences with preclinical exercises to enhance students' proficiency in cleaning, shaping, and performing root canal fillings. Therefore, this study aimed to radiographically evaluate the technical quality of root canal fillings performed by preclinical students on extracted teeth at the College of Dentistry, University of Ha'il, Saudi Arabia. METHODS: A total of 788 extracted human teeth received root canal treatment by undergraduate students. The samples were then gathered and radiographically assessed using the three quality criteria of length, density, and taper. The category of root canal fillings was classified as either acceptable or unacceptable. The criteria for evaluating the acceptability of filling quality were defined based on the presence of adequate length, density, and taper. The effectiveness of root canal fillings was also evaluated in relation to the tooth type, sex, and treatment year. The agreement between the examiners was evaluated using Cohen's kappa test, and the relationship between the research variables was determined using the chi-squared test. The significance threshold was set at 0. 05. RESULTS: The overall quality of root filling was determined to be satisfactory in 532 (67.5%) of 788 endodontically treated extracted teeth. The majority of the research sample (88.1%) had enough length, 89.6% had adequate density, and 86.4% had acceptable taper. The quality of anterior teeth was substantially better than that of posterior teeth (p < 0.001). Our findings showed that the quality of root canals was better in 2022 than it had been in earlier years (p = 0.001). The three RCT quality criteria differed significantly when compared between sexes (p = 0.002). CONCLUSIONS: The quality of the root canal fillings completed by undergraduate students was rated as acceptable. The findings of the research suggest that the implementation of routine assessments to evaluate the technical competence of undergraduate dental students performing root canal treatments could provide significant insights into the efficacy of the curriculum requirements.

Comparing Common Risk Assessment Tools to Predict Outcomes in Total Knee Arthroplasty.

BACKGROUND: A number of tools exist to aid surgeons in risk assessment, including the Charlson Comorbidity Index (CCI), the Elixhauser Comorbidity Index (ECI), and various measures of frailty, such as the Hospital Frailty Risk Score (HFR). While all of these tools have been validated for general use, the best risk assessment tool is still debated. Risk assessment is particularly important in elective surgery, such as total joint arthroplasty. The aim of this study is to compare the predictive power of the CCI, ECI, and HFR in the setting of total knee arthroplasty (TKA). METHODS: All patients who underwent TKA were identified via International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code from the National Readmissions Database, years 2016 to 2019. Patient demographics, perioperative complications, and hospital-associated outcomes were recorded. Receiver operating characteristic (ROC) curves were created and area under the curves (AUCs) evaluated to gauge the predictive capabilities of each risk assessment tool (CCI, ECI, and HFR) across a range of outcomes. RESULTS: A total of 1,930,803 patients undergoing TKA were included in our analysis. For mortality, ECI was most predictive (0.95 AUC), while HFR and CCI were 0.75 and 0.74 AUC, respectively. For periprosthetic fractures, ECI was 0.78 AUC, HFR was 0.68 AUC, and CCI was 0.66 AUC. For joint infections, the ECI was 0.78 AUC, the HFR was 0.63 AUC, and the CCI was 0.62 AUC. For 30-day readmission, ECI was 0.79 AUC, while HFR and CCI were 0.6 AUC. For 30-day reoperation, ECI was 0.69 AUC, while HFR was 0.58 AUC and CCI was 0.56 AUC. CONCLUSIONS: Our analysis shows that ECI is superior to CCI and HFR for predicting 30-day postoperative outcomes following TKA. Surgeons should consider assessing patients using ECI prior to TKA.

An Integrative Review of Social Determinants of Glycemic Targets Achievement in Adults with Type 2 Diabetes in the United States.

Several individual social determinants of health have been identified as significant factors contributing to achieving glycemic targets (glycated hemoglobin < 7). However, it remains unclear how these social variables individually or collectively contribute to glycemic targets among adults with type 2 diabetes (T2D) in the United States (U.S.) The purpose of the current integrative review (IR) was to describe and synthesize findings from studies on social determinants of glycemic target achievement in adults with T2D in the U.S. and integrate them into the United States Department of Health and Human Services Conceptual Framework. The databases searched included PubMed, CINAHL Plus with Full Text, Medline with Full Text [EBSCO], Google Scholar, bibliography, and hand searching. A total of 948 records were identified. After excluding duplicates and irrelevant studies based on inclusion and exclusion criteria through title, abstract, and full-text screening, 13 studies were finally included in this IR. The results revealed that race/ethnicity, economic access and stability, educational access and quality, healthcare access and quality, neighborhood and built environment, and social and community context contribute to glycemic target achievement among adult patients with T2D in the U.S. Integrating findings from key studies on social determinants of glycemic health may contribute to developing interventions aimed at reducing and eventually eradicating health disparities for individuals with and at risk for T2D in the U.S.

Assessment of lifestyle changes related to quarantine among Saudi population during the early COVID-19 pandemic: pre- and post-analysis.

BACKGROUND: The escalating emergence of the COVID-19 pandemic interrupted human life due to the ever-increasing morbidity, containment measures, and the associated emotional distress. This study examined the influence of COVID-19-related measures on the lifestyle behaviors of adults living in the Kingdom of Saudi Arabia (KSA). METHODS: The study recruited 638 participants through convenience sampling in Jeddah and Taif cities, Saudi Arabia. Demographic characteristics and COVID-19-related information were collected through an anonymous self-reported electronic questionnaire. Lifestyle behaviors were assessed before and during the quarantine using the Healthy Dietary Habits Index (HDHI)-A and the International Physical Activity Questionnaire (IPAQ-SF). RESULTS: The study revealed significant changes in the dietary pattern: a reduction in fish intake and increased consumption of French fries and candies. Vegetables and fruit intake increased significantly. Sedentary time > 6 h per day increased from 36.7% pre to 60.8% during the pandemic. Healthy dietary index score and physical activity MET-minutes/week values were respectively 3.5% and 37.9% significantly higher before compared to the full quarantine period. CONCLUSION: The pandemic detrimentally influenced eating habits and physical activity levels that led to weight gain, and hence higher vulnerability to COVID-19 infection and negative outcomes. This analysis provides public health agencies with data to tailor nutrition interventions that mitigate the observed adverse lifestyle behaviors.

Distribution, speciation, and assessment of heavy metals in sediments from Wadi Asal, Red Sea, Egypt.

Globally, the environmental contamination of stream sediments due to geogenic and anthropogenic sources is of growing concern. In this study, the heavy metals (Cd, Co, Cr, Cu, Ni, Pb, and Zn) in 22 superficial sediments in Wadi Asal, Red Sea, Egypt, were explored to assess sediment sources, the mobility of chemical species, and the degree of contamination in sediments. Therefore, the total heavy metal values in the fine fraction (< 63 µm), a five-step sequential extraction on selective samples, risk assessment, and principal component analysis (PCA) were applied. The mobility of heavy metals in Wadi Asal sediments, according to non-residual fraction percent, declines in the following order: Cd (90.9%) > Pb (85.2%) > Co (84.4%) > Cu (80.8%) > Zn (75.9%) > Ni (48.4%) > Cr (39.6%); indicating the high mobility of Cd, Zn, Pb, Cu, and Co. The mean metal contamination factor (CF) order is Cd (10.96) > Ni (3.91) > Cr (2.77) > Zn (2.18) > Pb (2.10) > Co (1.12) > Cu (0.70). The Geo-accumulation Index (Igeo) is decreased in the following order: Cd (2.19) > Ni (0.78) > Cr (0.55) > Zn (0.44) > Pb (0.42) > Co (0.22) > Cu (0.14). The risk assessment code (RAC) revealed very high to high risk for Cd, Co, and Pb. The results pointed out that the metals Cr, Co, Cu, and Ni are from geogenic sources, while Zn, Cd, and Pb are from anthropogenic sources due to Pb-Zn mining activities. Based on the threshold effect level (TEL), Cd, Cr, Ni, and Pb have adverse effects on living organisms. According to these findings, the area along Wadi Asal and the downstream regions on the beach are highly polluted and heavy metal monitoring in sediments and aquatic organisms is recommended.

Coal fly ash and bottom ash low-cost feedstocks for CO2 reduction using the adsorption and catalysis processes.

Combustion of fossil fuels, industry and agriculture sectors are considered as the largest emitters of carbon dioxide. In fact, the emission of CO2 greenhouse gas has been considerably intensified during the last two decades, resulting in global warming and inducing variety of adverse health effects on human and environment. Calling for effective and green feedstocks to remove CO2, low-cost materials such as coal ashes "wastes-to-materials", have been considered among the interesting candidates of CO2 capture technologies. On the other hand, several techniques employing coal ashes as inorganic supports (e.g., catalytic reduction, photocatalysis, gas conversion, ceramic filter, gas scrubbing, adsorption, etc.) have been widely applied to reduce CO2. These processes are among the most efficient solutions utilized by industrialists and scientists to produce clean energy from CO2 and limit its continuous emission into the atmosphere. Herein, we review the recent trends and advancements in the applications of coal ashes including coal fly ash and bottom ash as low-cost wastes to reduce CO2 concentration through adsorption and catalysis processes. The chemical routes of structural modification and characterization of coal ash-based feedstocks are discussed in details. The adsorption and catalytic performance of the coal ashes derivatives towards CO2 selective reduction to CH4 are also described. The main objective of this review is to highlight the excellent capacity of coal fly ash and bottom ash to capture and selective conversion of CO2 to methane, with the aim of minimizing coal ashes disposal and their storage costs. From a practical view of point, the needs of developing new advanced technologies and recycling strategies might be urgent in the near future to efficient make use of coal ashes as new cleaner materials for CO2 remediation purposes, which favourably affects the rate of global warming.