The Prevalence of Sleep Disorders in People with Type 2 Diabetes and Obesity in Saudi Arabia: A Cross-Sectional Study.

Purpose: Difficulty falling or staying asleep are considered sleep disorders, and these are common among people with type 2 diabetes mellitus (T2DM) and obesity. The presence of sleep disorders may cause poor glycemic control among this population. We therefore designed this study to assess sleep disorders among patients with T2DM and obesity. Patients and Methods: This cross-sectional study examined the prevalence of sleep disorders in 148 patients with T2DM and obesity at a hospital in Taif, Saudi Arabia using a validated questionnaire. Results: Among those patients who have been involved in this study, we found a moderate level of sleep disorders and disturbances. The average sleep disorder assessment score for the patients with T2DM and obesity was 2.8 ± 1.4. Additionally, the average score for the sleep pattern assessment was 2.7 ± 1.3 and 2.9 ± 1.5 for symptoms of lack of sleep. Our study also revealed that those patients also had suboptimal weight and glycemic control. Conclusion: These findings demonstrate that patients with T2DM and obesity are at a higher risk of developing sleep disorders. Therefore, these patients need to be screened for sleep disorders to avoid further diabetes-related complications and to have an early lifestyle intervention.

Level of and factors associated with foot self-care among people with diabetes in Idlib Province of Northwest Syria: A cross-sectional study.

Background and aims: Diabetic foot and lower limb problems are among the most neglected complications during the Syrian armed conflict due to the absence of a functioning health infrastructure, including early detection and timely management of limb-threatening wounds. This study aimed to determine self-reported diabetes-related foot disease (DRFD), adherence to recommended foot self-care (FSC) practices, and associated factors among people with diabetes in war-torn Northwest Syria (NWS). Methods: This was a cross-sectional study conducted at six primary care clinics in Idlib, NWS, between March 27 and April 17, 2022, utilizing the validated interviewer-administered Diabetes Foot Disease and Foot Care Questionnaire. Data on demographic characteristics, DRFD, and FSC practices were collected. FSC score was determined by adding the points from all 12 FSC items, with a maximum score of 48, and were categorized into very poor (≤12), poor (13-24), moderate (25-36), and good (37-48). A convenience sample of 331 consecutive Syrians, aged ≥18 years, with diabetes, were invited. Multiple linear regression was used to identify variables associated with FSC practices. Results: A total of 328 patients completed the questionnaire (response rate: 99.1%). The overall FSC score was average (mean total score 27.24, SD 7.03). Over one-third (37.8%) had a very poor/poor score, 50.3% had an average score, and 11.9% had a good score. Household income/month of ≥51 USD (ß = 2.6, 95% confidence interval [95% CI]:1.06-4.1, p = 0.001) and diabetes duration of ≥10 years (ß = 1.8, 95% Cl: 0.2-3.4, p = 0.027) significantly predicted better FSC practice. Conclusion: A significant proportion of participants had inadequate adoption FSC behaviors. Higher socioeconomic status was associated with better FSC practices. Future research should evaluate diabetic foot education and professional foot care in this population.

Programming Probiotics: Diet-Responsive Gene Expression and Colonization Control in Engineered S. boulardii.

Saccharomyces boulardii (Sb) is an emerging probiotic chassis for delivering biomolecules to the mammalian gut, offering unique advantages as the only eukaryotic probiotic. However, precise control over gene expression and gut residence time in Sb have remained challenging. To address this, we developed five ligand-responsive gene expression systems and repaired galactose metabolism in Sb, enabling inducible gene expression in this strain. Engineering these systems allowed us to construct AND logic gates, control the surface display of proteins, and turn on protein production in the mouse gut in response to dietary sugar. Additionally, repairing galactose metabolism expanded Sb's habitat within the intestines and resulted in galactose-responsive control over gut residence time. This work opens new avenues for precise dosing of therapeutics by Sb via control over its in vivo gene expression levels and localization within the gastrointestinal tract.

Potential antioxidant, α-glucosidase, butyrylcholinesterase and acetylcholinesterase inhibitory activities of major constituents isolated from Alpinia officinarum hance rhizomes: computational studies and in vitro validation.

Alpinia officinarum is a commonly used spice with proven folk uses in various traditional medicines. In the current study, six compounds were isolated from its rhizomes, compounds 1-3 were identified as diarylheptanoids, while 4-6 were identified as flavonoids and phenolic acids. The isolated compounds were subjected to virtual screening against α-glucosidase, butyrylcholinesterase (BChE), and acetylcholinesterase (AChE) enzymes to evaluate their potential antidiabetic and anti-Alzheimer's activities. Molecular docking and dynamics studies revealed that 3 exhibited a strong binding affinity to human a α- glucosidase crystal structure compared to acarbose. Furthermore, 2 and 5 demonstrated high potency against AChE. The virtual screening results were further supported by in vitro assays, which assessed the compounds' effects on α-glucosidase, cholinesterases, and their antioxidant activities. 5-Hydroxy-7-(4-hydroxy-3-methoxyphenyl)-1-phenylheptan-3-one (2) showed potent antioxidant effect in both ABTs and ORAC assays, while p-hydroxy cinnamic acid (6) was the most potent in the ORAC assay. In contrary, kaempferide (4) and galangin (5) showed the most potent effect in metal chelation assay. 5-Hydroxy-1,7-diphenylhepta-4,6-dien-3-one (3) and 6 revealed the most potent effect as α-glucosidase inhibitors where compound 3 showed more potent effect compared to acarbose. Galangin (5) revealed a higher selectivity to BChE, while 2 showed the most potent activity to (AChE).

Techno-economic and environmental analysis for the application of renewable energy sources in seaports.

Ports have an indisputable effect on the decarbonization of urban areas, helping to minimize air and environmental pollution and achieve sustainable development. In this instance, it is crucial to do research that can advance our understanding of how to increase ports' energy independence by utilizing renewable energy sources. The current study aims to study the environmental benefits and techno-economic challenges of converting three Egyptian ports to eco-friendly green ports by using solar panels, offshore wind turbines, and hydrogen fuel cells. The study shows that from a technical point of view, the required green power to be installed at Alexandria, Port Said, and Suez ports is around 13 MW, 5 MW, and 1.5 MW, respectively. Furthermore, the environmental analysis findings demonstrate that integrating green energy will significantly lower emissions in seaports. It is anticipated that the ports of Alexandria, Port Said, and Suez will achieve annual reductions in carbon dioxide emissions of roughly 68,7 k-tons, 25,8 k-tons, and 6,4 k-tons, respectively. From an economic point of view, the ports could be supplied with green energy from wind turbines for a cost of between 0.115 and 0.125 USD/kWh, while solar panels have a cost range of 0.098 to 0.129 USD/kWh. Additionally, hydrogen fuel cell systems cost about 0.102 USD/kWh.

Biomechanical and ergonomic risks associated with cervical musculoskeletal dysfunction amongst surgeons: A systematic review.

INTRODUCTION: Surgeons are at high risk of developing musculoskeletal symptoms due to a range of factors including, maladaptive positioning and surgical ergonomics. Cervical muscle strain and biomechanical load is most prevalent due to repetitive motions and prolonged static neck positioning. This issue is apparent through reports of prevalence between 10 and 74.4% among surgeons. The aim of this systematic review is to provide an objective assessment of the clinical evidence available and a descriptive analysis of the effects of kinematics and surgical ergonomics on the prevalence of surgeons' cervical musculoskeletal pain. METHODS: This is PRISMA-compliant systematic review of clinical studies assessing the prevalence of cervical musculoskeletal dysfunction in surgeons by searching PUBMED and Ovid EMBASE databases from inception to 19th October 2023. Study quality was graded according to the National Institutes of Health study quality assessment tools. RESULTS: A total of 9 studies were included in the final qualitative analysis. The use of loupes, open surgery and excessive neck flexion (>30°) were associated with cervical dysfunction. Comparison of study outcomes was challenging due to heterogeneity within study methods and the paucity of methodological quality. CONCLUSION: The current literature assessing ergonomic and biomechanical factors predisposing surgeons to cervical musculoskeletal dysfunction is insufficient to provide reliable guidance for clinicians. Although the literature identifies factors contributing to work-related cervical dysfunction, few attempt to evaluate interventions for improved surgical ergonomics. An objective assessment of interventions that prompt postural correction with the aim to improve neck pain in surgeon cohorts is warranted.

Trends in the Management of Miscarriages with the Implementation of the Volunteer Obstetrician Scheme in Selected Primary Health Care Centres in Maiduguri, Northeastern Nigeria.

BACKGROUND: Post-abortion care (PAC) is a crucial component of emergency obstetric care, and many of the primary health care centres (PHC) in the internally displaced person (IDP) camps and host communities in Maiduguri lack it. Improved access to high-quality PACs is essential for meeting the reproductive health needs of the IDPs and reducing the maternal morbidity and mortality that can result from miscarriages. OBJECTIVE: To determine the trend in managing miscarriages in the IDP camps and host communities in Maiduguri and the impact of the volunteer obstetrician scheme (VOS) on PAC. METHODOLOGY: We conducted a longitudinal study in selected PHCs serving IDP camps and host communities in Maiduguri. The study spanned five (5) years, and we compared the management of miscarriages and PAC services one year before the VOS project, two years during the project and two years after the project. During the two-year VOS project, staff manning the PHCs had supportive supervision with hands-on training on PAC. Chi-square for trend and odd ratio with a 95% confidence interval was used as appropriate to compare the trend in PAC services provided during the study period. RESULTS: One thousand eight hundred and eight (1808) women presented with miscarriages, and 1562 (86.4%) required uterine evacuation. Medical evacuation with oral misoprostol was offered to 974 (62.4%), and manual vacuum aspiration (MVA) was used in 422 (27.0%) of the women who needed uterine evacuation. There was a statistically significant rise in the use of medical evacuation throughout the study period (52.2% before VOS, and 71.4% by the second year of VOS) with ꭓ2=41.64 and P<0.001. In comparison, the use of MVA fell from 38.6% in 2015 to 27.7% in 2019 (ꭓ2=34.74 and P<0.001). Similar rising trends were also observed in postabortion family planning acceptance (ꭓ2=22.27, P<0.001). CONCLUSION: The Volunteer Obstetrician Scheme project appears to have improved PAC services, especially medical evacuation and family planning uptake in the PHCs in IDP camps and host communities in Maiduguri, Borno State, Nigeria. We recommend task shifting of PAC services and periodic supportive supervision to ensure the quality of care.

CONTEXTE: Les soins après avortement (PAC) sont une composante cruciale des soins obstétricaux d'urgence, et de nombreux centres de soins de santé primaires (PHC) dans les camps de personnes déplacées internes (PDI) et les communautés d'accueil à Maiduguri en sont dépourvus. Un accès amélioré à des PAC de haute qualité est essentiel pour répondre aux besoins de santé reproductive des PDI et réduire la morbidité et la mortalité maternelles qui peuvent résulter des fausses couches. OBJECTIF: Déterminer la tendance dans la gestion des fausses couches dans les camps de PDI et les communautés d'accueil à Maiduguri et l'impact du Programme de bénévoles obstétriciens (VOS) sur la PAC. MÉTHODOLOGIE: Nous avons mené une étude longitudinale dans des PHC sélectionnés desservant des camps de PDI et des communautés d'accueil à Maiduguri. L'étude a duré cinq (5) ans, et nous avons comparé la gestion des fausses couches et les services de PAC un an avant le projet VOS, deux ans pendant le projet et deux ans après le projet. Pendant les deux ans du projet VOS, le personnel des PHC a bénéficié d'une supervision avec formation pratique sur la PAC. Le chi carré pour la tendance et le rapport de cotes avec un intervalle de confiance de 95% ont été utilisés, le cas échéant, pour comparer la tendance des services de PAC fournis pendant la période de l'étude. RÉSULTATS: Mille huit cent huit (1808) femmes ont présenté des fausses couches, et 1562 (86,4%) ont nécessité une évacuation utérine. Une évacuation médicale avec du misoprostol oral a été proposée à 974 (62,4%), et l'aspiration manuelle sous vide (AMV) a été utilisée chez 422 (27,0%) des femmes ayant besoin d'une évacuation utérine. On a observé une augmentation statistiquement significative de l'utilisation de l'évacuation médicale tout au long de la période de l'étude (52,2% avant le VOS et 71,4% la deuxième année du VOS) avec ꭓ2=41,64 et P<0,001. En revanche, l'utilisation de l'AMV est passée de 38,6% en 2015 à 27,7% en 2019 (ꭓ2=34,74 et P<0,001). Des tendances similaires à la hausse ont également été observées dans l'acceptation de la planification familiale après avortement (ꭓ2=22,27, P<0,001). CONCLUSION: Le projet de Programme de bénévoles obstétriciens semble avoir amélioré les services de PAC, en particulier l'évacuation médicale et l'acceptation de la planification familiale dans les PHC des camps de PDI et des communautés d'accueil à Maiduguri, dans l'État de Borno, au Nigéria. Nous recommandons de déléguer les services de PAC et une supervision de soutien périodique pour garantir la qualité des soins. MOTS-CLÉS: Communauté d'accueil, Camps de PDI, Aspiration manuelle sous vide, Évacuation médicale, Misoprostol, Soins après avortement.

DES-ultrasonication treatment of cellulose nanocrystals and the reinforcement in carrageenan biocomposite.

CNCs are intensively studied to reinforce biocomposites. However, it remains a challenge to homogeneously disperse the CNC in biocomposites for a smooth film surface. Mechanochemical treatment via ultrasonication in deep eutectic solvent (DES) generated a stable dispersion of CNC before incorporation into carrageenan biocomposite. Shifted peaks of choline chloride (ChCl) methylene groups to 3.95-3.98 ppm in 1H NMR indicated a formation of eutectic mixture between the hydrogen bond acceptor (HBA) and hydrogen bond donor (HBD) at the functional group of CH3···OH. The swelling of CNC in the DES was proven by the formation of intermolecular H-bond at a length of 2.46 Å. The use of DES contributed to a good dispersion of CNC in the solution which increased zeta potential by 43.2 % compared to CNC in deionized water. The ultrasonication amplitude and feed concentration were varied for the best parameters of a stable dispersion of CNC. The crystallinity of 1 wt% of CNC at 20 % sonication amplitude improved from 76 to 81 %. The high crystallinity of CNCDES resulted in an increase in film tensile and capsule loop strength of Carra-CNCDES by 20.7 and 19.4 %, respectively. Improved dispersion of CNCDES reduced the surface roughness of the biocomposite by 21.8 %. H-bond network in CNCDES improved the biocomposite properties for an ingenious reinforcement material.

What We Know About the Actual Role of Traditional Probiotics in Health and Disease.

The complex relationship between probiotics and human health goes beyond their traditional function in gut health, generating considerable interest for their broad potential in disease treatment. This review explores the various functions of probiotics, highlighting their impact on the immune system, their benefits for gut and oral health, their effects on metabolic and neurological disorders, and their emerging potential in cancer therapy. We give significant importance to studying the effects of probiotics on the gut-brain axis, revealing new and non-invasive therapeutic approaches for complex neurological disorders. In addition, we expand the discussion to encompass the impact of probiotics on the gut-liver and gut-lung axes, recognizing their systemic effects and potential in treating respiratory and hepatic conditions. The use of probiotic "cocktails" to improve cancer immunotherapy outcomes indicates a revolutionary approach to oncological treatments. The review explores the specific benefits associated with various strains and the genetic mechanisms that underlie them. This study sets the stage for precision medicine, where probiotic treatments can be tailored to meet the unique needs of each patient. Recent developments in delivery technologies, including microencapsulation and nanotechnology, hold great potential for enhancing the effectiveness and accuracy of probiotic applications in therapeutic settings. This study provides a strong basis for future scientific research and clinical use, promoting the incorporation of probiotics into treatment plans for a wide range of diseases. This expands our understanding of the potential benefits of probiotics in modern medicine.

Low concentrations of soybean lecithin nanoparticles had a positive impact on Holstein bulls' cryopreserved semen.

Spermatozoa can experience negative changes when subjected to freezing and thawing, including lowered motility, viability and acrosome response. Herein, the effects of different concentrations of soybean lecithin nanoparticles on cryopreserved Holstein bull semen were examined. Semen was collected, cryopreserved and utilized for sperm kinetic parameter analysis following dilution, equilibration and thawing with 0.5% soybean lecithin (E1), the control extender, and 0.75% (E2), 0.5% (E3), 0.25% (E4) and 0.125% (E5) of lecithin nanoparticles. Results revealed that following dilution, the progressive motility (PM) at E3, E4 and E5 of lecithin nanoparticles was higher (p < .05) than it was for E2. After equilibration, compared to the E1, E2, and E3 values, the PM, vitality, normal morphology, membrane integrity and intact acrosome values at the E5 were consistently greater (p < .05). Comparing the percentages of intact acrosome and membrane integrity at E2 and E3 to E4 and E5, a substantial decrease (p < .05) was seen. Following thawing, the percentage of PM improved at E2 and E5, even though their mean PM values were similar (p > .05) compared to E1, E3 and E4. Vigour and progression parameters of sperm (DAP, DCL, DSL, VAP, VCL, VSL and STR) at E5 were higher (p < .05) than those at E1, E2, E3 and E4. In conclusion, the cryopreserved sperm from Holstein bulls revealed outstanding properties both after equilibration and after thawing with 0.125% lecithin nanoparticles, and they were sensitive to high dosages.

Tuning Excited State Character in Iridium(III) Photosensitizers and Its Influence on TTA-UC.

A series of mixed ligand, photoluminescent organometallic Ir(III) complexes have been synthesized to incorporate substituted 2-phenyl-1H-naphtho[2,3-d]imidazole cyclometalating ligands. The structures of three example complexes were categorically confirmed using X-ray crystallography each sharing very similar structural traits including evidence of interligand hydrogen bond contacts that account for the shielding effects observed in the 1H NMR spectra. The structural iterations of the cyclometalated ligand provide tuning of the principal electronic transitions that determine the visible absorption and emission properties of the complexes: emission can be tuned in the visible region between 550 and 610 nm and with triplet lifetimes up to 10 µs. The nature of the emitting state varies across the series of complexes, with different admixtures of ligand-centered and metal-to-ligand charge transfer triplet levels evident. Finally, the use of the complexes as photosensitizers in triplet-triplet annihilation energy upconversion (TTA-UC) was investigated in the solution state. The study showed that the complexes possessing the longest triplet lifetimes showed good viability as photosensitizers in TTA-UC. Therefore, the use of an electron-withdrawing group on the 2-phenyl-1H-naphtho[2,3-d]imidazole ligand framework can be used to rationally promote TTA-UC using this class of complex.

Outcome of Endoprosthesis used in Limb Salvage Surgery in a Malaysian Orthopaedic Oncology Centre.

Introduction: To describe the duration of survival among bone tumour patients with endoprosthesis reconstruction and to determine frequency of implant failure, revision of surgery, and amputation after endoprosthesis reconstruction. Materials and methods: A retrospective cross-sectional review of all patients with either primary bone tumour or secondary bone metastases treated with en bloc resection and endoprosthesis reconstruction from January 2008 to December 2020. Results: A total of 35 failures were recorded among the 27 (48.2%) patients with endoprostheses. Some of the patients suffered from one to three types of modes of failure on different timelines during the course of the disease. Up to eight patients suffered from more than one type of failure throughout the course of the disease. Out of all modes of failure, local recurrence (type 5 failure) was the most common, accounting for 25.0% of all failure cases. Four patients (7.1%) eventually underwent amputation, which were either due to infection (2 patients) or disease progression causing local recurrence (2 patients). Conclusion: The overall result of endoprosthesis reconstruction performed in our centre was compatible with other centres around the world. Moreover, limb salvage surgery should be performed carefully in a selected patient group to maximise the benefits of surgery.

Arsenic's shadowy influence: A systematic review of its carcinogenic role in gallbladder cancer.

INTRODUCTION: Gallbladder carcinoma (GBC) and cholangiocarcinoma are aggressive forms of cancer developed in the gallbladder and biliary tracts which are related to the liver. This systematic review aimed to highlight the significant association between gallbladder, biliary cancers, and arsenic exposure. METHODS: An extensive search was conducted in Embase, Cochrane, Scopus, PubMed, and Web of Science. We included studies that assessed arsenic levels in gallbladder cancer patients, without restrictions on age, sex, or language. Biological samples, such blood, bile, gallbladder tissue, gallstones, and hair were obtained, and arsenic levels were measured. Also, arsenic water and soil concentrations were collected. RESULTS: A total of 13 studies were included in our review. These studies included 2234 non-gallbladder carcinoma patients and 22 585 gallbladder carcinoma cases. The participant demographics showed a gender distribution of 862 males and 1845 females, with an age range of 20-75 years. The average body mass index (BMI) was 19.8 kg/m2 for nongallbladder carcinoma patients and 20.1 kg/m2 for gallbladder carcinoma cases. The selected studies examined arsenic concentrations across various biological samples, including blood, hair, gallstones, and bile. Blood arsenic levels ranged from 0.0002 to 0.3893 µg/g and were significantly associated with increased gallbladder carcinoma risk in several studies. Hair also demonstrated a significant correlation, with arsenic concentrations ranging from 0.0002 to 6.9801 µg/g. CONCLUSION: There is a strong link between arsenic exposure and gallbladder cancer or cholangiocarcinoma. Even chronic exposure to low-moderate amounts could lead to gallbladder carcinoma. These findings stress the need for more comprehensive and dedicated studies, to control arsenic water/soil levels and seek other preventive measures for this high mortality disease.

A comprehensive investigation of Bi2O3 on the physical, structural, optical, and electrical properties of K2O.ZnO.V2O5.B2O3 glasses.

The multi-component glass system has a composition of 10K2O-10ZnO-55 B2O3-(25-x)V2O5-xBi2O3 (x = 4, 5, 7.5, 9, 10 mol%) are synthesized by the melt-quenching method. Using X-ray diffraction examination, the amorphous phase in the material was confirmed. The physical characteristics of the produced compositions are examined using density (D) and molar volume (Vm). Calculations of physical properties showed that adding Bi2O3 from 4 to 10 mol% increased the glass density from 2.7878 to 3.3617 g cm-3 and decreased the molar volume from 40.4196 to 38.5895 cm3/mol. Studies of glass samples using the FTIR show bands of absorption for oxides in different structural groups. Octahedral [ BiO 6 ], [ BO 4 ], and tetrahedral [ BO 3 ] structural units are observed in the present glass matrices. The cutoff wavelength ( λ C ), and optical band gap energy were determined using UV absorption spectra. The increase in non-bridging oxygens can be linked to the decrease in optical band gap energy ( E opt ) (direct and indirect) and the increase in cutoff wavelength with an increase in Bi2O3 content. This is attributed to the existence of bismuth ions and the creation of non-bridging oxygens. Besides that, the values of optical parameters, viz., optical electronegativity, refractive index, and molar refractivity, are calculated. The metallization criterion values are less than 1 and the glass samples exhibit an increased tendency towards metallization. Both the conductivity and the dielectric constant increase with the rise in Bi2O3 content, however, the dielectric loss and the impedance reduce. The behavior and values of conductivity for the studied glasses reveal the semiconducting properties of all glass samples. These results suggest that the produced glass samples may be employed as amorphous semiconductors in electronics and memory switching devices.

Adapting Laplace residual power series approach to the Caudrey Dodd Gibbon equation.

In real-life applications, nonlinear differential equations play an essential role in representing many phenomena. One well-known nonlinear differential equation that helps describe and explain many chemicals, physical, and biological processes is the Caudrey Dodd Gibbon equation (CDGE). In this paper, we propose the Laplace residual power series method to solve fractional CDGE. The use of terms that involve fractional derivatives leads to a higher degree of freedom, making them more realistic than those equations that involve the derivation of an integer order. The proposed method gives an easy and faster solution in the form of fast convergence. Using the limit theorem of evaluation, the experimental part presents the results and graphs obtained at several values of the fractional derivative order.

A Spatial Interpolation Approach to Assign Magnetic Resonance Imaging-Derived Material Properties for Finite Element Models of Adeno-Associated Virus Infusion Into a Recurrent Brain Tumor.

Adeno-associated virus (AAV) is a clinically useful gene delivery vehicle for treating neurological diseases. To deliver AAV to focal targets, direct infusion into brain tissue by convection-enhanced delivery (CED) is often needed due to AAV's limited penetration across the blood-brain-barrier and its low diffusivity in tissue. In this study, computational models that predict the spatial distribution of AAV in brain tissue during CED were developed to guide future placement of infusion catheters in recurrent brain tumors following primary tumor resection. The brain was modeled as a porous medium, and material property fields that account for magnetic resonance imaging (MRI)-derived anatomical regions were interpolated and directly assigned to an unstructured finite element mesh. By eliminating the need to mesh complex surfaces between fluid regions and tissue, mesh preparation was expedited, increasing the model's clinical feasibility. The infusion model predicted preferential fluid diversion into open fluid regions such as the ventricles and subarachnoid space (SAS). Additionally, a sensitivity analysis of AAV delivery demonstrated that improved AAV distribution in the tumor was achieved at higher tumor hydraulic conductivity or lower tumor porosity. Depending on the tumor infusion site, the AAV distribution covered 3.67-70.25% of the tumor volume (using a 10% AAV concentration threshold), demonstrating the model's potential to inform the selection of infusion sites for maximal tumor coverage.

How far has diabetes-related foot disease research progressed in Australia? A bibliometric review (1970-2023).

BACKGROUND: Diabetes-related foot disease (DFD) is a leading cause of the Australian and global disease burdens and requires proportionate volumes of research to address. Bibliometric analyses are rigorous methods for exploring total research publications in a field to help identify volume trends, gaps and emerging areas of need. This bibliometric review aimed to explore the volume, authors, institutions, journals, collaborating countries, research types and funding sources of Australian publications investigating DFD over 50 years. METHODS: A systematic search of the Scopus® database was conducted by two independent authors to identify all Australian DFD literature published between 1970 and 2023. Bibliometric meta-data were extracted from Scopus®, analyzed in Biblioshiny, an R Statistical Software interface, and publication volumes, authors, institutions, journals and collaborative countries were described. Publications were also categorised for research type and funding source. RESULTS: Overall, 332 eligible publications were included. Publication volume increased steadily over time, with largest volumes (78%) and a 7-fold increase over the last decade. Mean co-authors per publication was 5.6, mean journal impact factor was 2.9 and median citation was 9 (IQR2-24). Most frequent authors were Peter Lazzarini (14%), Vivienne Chuter (8%) and Jonathon Golledge (7%). Most frequent institutions affiliated were Queensland University Technology (33%), University Sydney (30%) and James Cook University (25%). Most frequent journals published in were Journal Foot and Ankle Research (17%), Diabetic Medicine (7%), Journal Diabetes and its Complications (4%) and International Wound Journal (4%). Most frequent collaborating countries were the United Kingdom (9%), the Netherlands (6%) and the United States (5%). Leading research types were etiology (38%), treatment evaluation (25%) and health services research (13%). Leading funding sources were no funding (60%), internal institution (16%) and industry/philanthropic/international (10%). CONCLUSIONS: Australian DFD research increased steadily until more dramatic increases were seen over the past decade. Most research received no funding and mainly investigated etiology, existing treatments or health services. Australian DFD researchers appear to be very productive, particularly in recent times, despite minimal funding indicating their resilience. However, if the field is to continue to rapidly grow and address the very large national DFD burden, much more research funding is needed in Australia, especially targeting prevention and clinical trials of new treatments in DFD.

Parental Knowledge Toward Meningococcal Disease and Vaccination in Makkah Region, Saudi Arabia: A Cross-Sectional Study.

Background Invasive meningococcal disease (IMD) is a bacterial infection caused by Neisseria meningitidis, which primarily affects the meninges, with a high incidence in young children. The most effective technique for preventing IMD is vaccination, which has been available for over 40 years through meningococcal polysaccharide capsule-containing vaccines. This study aims to assess the parental knowledge of meningococcal disease and vaccination in the Makkah region of Saudi Arabia. Methodology A cross-sectional study was conducted between September and December 2023 among 597 parents in the Makkah region using a validated online survey. The collected data were analyzed using the Statistical Package for the Social Sciences (SPSS). Results The study sample included 597 parents, of which 339 (56.8%) were female and 258 (43.2%) were male. Our research demonstrated that 388 (65%) participants had an insufficient understanding of IMD, while 209 (35%) had a sufficient understanding. There was a significant correlation between the knowledge score and the completion of the routine vaccination and whether vaccinating a child is essential for the protection of other members of society. Conclusions Based on our study, only around one-third of the participants demonstrated a sufficient level of knowledge regarding IMD and its vaccination. To provide a more accurate assessment of the Saudi population, additional research should be conducted in various regions and cities.

Sporadic regional re-emergent cholera: a 19th century problem in the 21st century.

Cholera, caused by Vibrio cholerae, is a severe diarrheal disease that necessitates prompt diagnosis and effective treatment. This review comprehensively examines various diagnostic methods, from traditional microscopy and culture to advanced nucleic acid testing like polymerase spiral reaction and rapid diagnostic tests, highlighting their advantages and limitations. Additionally, we explore evolving treatment strategies, with a focus on the challenges posed by antibiotic resistance due to the activation of the SOS response pathway in V. cholerae. We discuss promising alternative treatments, including low-pressure plasma sterilization, bacteriophages, and selenium nanoparticles. The paper emphasizes the importance of multidisciplinary approaches combining novel diagnostics and treatments in managing and preventing cholera, a persistent global health challenge. The current re-emergent 7th pandemic of cholera commenced in 1961 and shows no signs of abeyance. This is probably due to the changing genetic profile of V. cholerae concerning bacterial pathogenic toxins. Given this factor, we argue that the disease is effectively re-emergent, particularly in Eastern Mediterranean countries such as Lebanon, Syria, etc. This review considers the history of the current pandemic, the genetics of the causal agent, and current treatment regimes. In conclusion, cholera remains a significant global health challenge that requires prompt diagnosis and effective treatment. Understanding the history, genetics, and current treatments is crucial in effectively addressing this persistent and re-emergent disease.