Associations between oxygen saturation Index and oxygenation index in neonates with congenital diaphragmatic hernia.

Objective: To explore the relationship between Oxygenation Index (OI) and Oxygen Saturation Index (OSI) among infants with Congenital Diaphragmatic Hernia (CDH), both within the first 24 h after birth and in extended observations in those who survived until their surgical intervention. Methods: Seven- years retrospective review of CDH cases at a single Level III neonatal intensive care unit. The correlations of various combinations of OI-OSI pairs were assessed using the Spearman's rho Correlation Coefficient. Additionally, during the initial 24 h, the correlations between admission (first), best (lowest), highest, and mean OI and OSI values were determined. The predictive ability of the first 24 h oxygen and oxygen saturation indices for mortality and other adverse outcomes were assessed using the Area Under the Curve (AUC) analysis. Results: Thirty-seven infants with CDH were included in the analysis. A strong correlation was observed between all pairs of OI/OSI (2,289) (Spearman's rho = 0.843), matched pairs of Postductal OI/OSI (1,232 pairs) (Spearman's rho = 0.835) and the unmatched pairs of Postductal OI and Preductal OSI (1,057 pairs) (Spearman's rho = 0.852). Using the regression equations for all pairs, matched and unmatched OI/OSI pairs, we deduced that for clinically pertinent OI thresholds of 10, 15, 20 and 40, the corresponding OSI values were 5, 8, 11, and 23, respectively. Furthermore, in the first 24 h, strong correlations were evident between OI/OSI: at admission (Spearman's rho = 0.783), best OI/OSI (Spearman's rho = 0.848), and highest OI/OSI (Spearman's rho = 0.921). The most robust correlation was observed between the mean OI/OSI with a Spearman's rho of 0.928. First (AUC = 0.849), best (AUC = 0.927), highest (AUC = 0.942) and mean day 1 OI (AUC = 0.946) were all predictive of mortality. Similarly, first (AUC = 1.00), best (AUC = 0.989), highest (AUC = 1.00) and the mean OSI in day 1 (AUC = 0.978) were all predictive of mortality. All of the OIs and OSIs in day 1 except for the admission OSI (AUC = 0.683) were predictive of pulmonary hypertension. Additionally, all of OI and OSI indices in the first 24-hour except for the best day 1 OI (AUC = 0.674) were predictive of the need for rescue HFOV. Conclusion: There were a strong correlation between the OI and OSI in infants with CDH. Oxygenation indices and OSI in the first 24 h were predictive of mortality and other adverse outcomes in infants with CDH.

The Impact of COVID-19 Vaccine Controversy on Parents' Perceptions of Routine Vaccinations.

Background The COVID-19 pandemic has significantly influenced public perceptions and behaviors related to vaccination. Understanding parental attitudes, knowledge gaps, and vaccination practices post-pandemic is crucial for informing effective public health strategies. This study aimed to investigate parental attitudes, knowledge, and practices toward routine childhood vaccination in the post-COVID-19 era, emphasizing shifts in perspectives and implications for vaccination strategies. Methodology A cross-sectional survey was conducted among 498 parents to assess their attitudes, knowledge, and practices regarding vaccination. Data were analyzed using descriptive statistics, chi-square tests, and t-tests where applicable, with p-values <0.05 considered statistically significant. Results The study revealed diverse parental attitudes toward vaccination post-COVID-19. While a majority (72.9%) maintained positive attitudes toward vaccination schedules and benefits, concerns regarding vaccine safety and efficacy were noted. Knowledge gaps persisted, with 16.5% strongly agreeing that children's vaccinations are weak and have no impact on disease prevention. Despite high adherence to vaccination schedules (68.9%), motivations behind vaccine administration were questioned, as 48.2% strongly disagreed that vaccination was solely for regulatory purposes. Conclusions Post-COVID-19, parental attitudes toward vaccination have evolved, reflecting increased concerns about safety and efficacy. Addressing knowledge gaps, combating misinformation, and enhancing trust in vaccination programs are imperative. Tailored communication strategies, education campaigns, and policy interventions are essential to promote vaccination acceptance and safeguard public health resilience in the post-pandemic era.

Protective effect of 5,4'-dihydroxy-6,8-dimethoxy7-O-rhamnosylflavone from Indigofera aspalathoides Vahl on lipopolysaccharide-induced intestinal injury in mice.

Intestinal inflammation is one of the main health challenges affecting the quality of life of millions of people worldwide. Accumulating evidence introduces several flavonoids with multifaceted therapeutic properties in inflammatory diseases including intestinal inflammation. Herein, we examined potential anti-inflammatory properties of 5,4'-dihydroxy-6,8-dimethoxy7-O-rhamnosylflavone (DDR) flavone derived from Indigofera aspalathoides Vahl (I. aspalathoides Vahl) on lipopolysaccharide (LPS)-induced intestinal inflammation and injury in mice. Oral DDR treatment decreased serum levels of pro-inflammatory cytokines including TNF-α, IL-6, and IL-1ß. It reduced oxidative stress through augmenting the activities of catalase (CAT) and superoxide dismutase (SOD) and reducing the level of malondialdehyde (MDA) in the duodenum and colon tissues. Moreover, DDR enhanced the activities of digestive enzymes including trypsin, pancreatic lipase, and amylase, and increased the production of short-chain fatty acids (SCFAs) by colon microbiota. Histopathological investigation of duodenum and colon revealed that DDR inhibited inflammatory infiltration and largely restored mucosal architecture and protected lining integrity. Importantly, DDR suppressed activation of nuclear factor-κB (NF-κB) signaling pathway through reduced expression of Toll-like receptor 4 (TLR4) and expression and phosphorylation of P65. The current study identified DDR as anti-inflammatory flavonoid capable of ameliorating LPS-induced intestinal inflammation through suppression of NF-κB signaling.

Anaplastic lymphoma kinase rearrangement-associated renal cell carcinoma: Rare subset case report.

Anaplastic lymphoma kinase rearrangement-associated renal cell carcinoma (ALK-RCC) is a rare subtype of renal cell carcinoma characterized by genetic rearrangements involving the ALK gene. Managing ALK-RCC is challenging due to its rarity and limited treatment options. Targeted therapies directed at the ALK gene have shown promise. ALK-RCC is a rare subtype of renal cell carcinoma with unique clinical and pathological features. ALK inhibitors may hold promise as a targeted therapy for ALK-RCC. Further research is needed to understand the behavior of ALK-RCC and develop effective treatment strategies.

The Role of Screening, Risk Factors, and Early Intervention in Preventing Diabetes in the Obese Population: A Systematic Review.

With its rising global prevalence, diabetes has become one of the most significant and challenging health problems afflicting the world's population today. The increasing burden of diabetes and its associated complications calls for immediate action for prevention which primarily includes addressing the risk factors. The most significant risk factor for the onset of diabetes is obesity. Obesity and diabetes rates have been rising simultaneously, posing a threat to patient mortality and driving up community healthcare costs. A weight loss of five percent or more of total body weight has been shown to improve the quality of life, reduce the need for pharmacological therapy for diabetes, and enhance glycemic control. This level of weight loss can have significant health benefits, particularly for individuals with diabetes or at risk for developing diabetes. We aim to conduct this systematic review to assess diverse risk factors contributing to the incidence of diabetes among the obese population and determine various preventive strategies and recommendations in practice for the prevention of diabetes in this cohort. As a result, we included original studies that recruited the obese and diabetic populations and defined preventive measures for early intervention. Additionally, we included studies published in the last 10 years (2014-2024) only for the latest evidence. Studies including obese populations with cardiovascular diseases and neurological disorders were excluded. The Newcastle-Ottoman Castle assessment tool was utilized to assess the quality of the studies. We included nine studies that recruited 60,645 patients and were published between 2015 and 2022. Findings suggest that obesity alone is a significant contributor to the occurrence or onset of diabetes. At the same time, the presence of other risk factors, including hypertension, dyslipidemia, elevated triglycerides, or HDL and LDL levels, may further increase the risk of diabetes and its associated complications among the obese population. Preventive strategies emphasize early intervention through increasing awareness and educating communities about risk factors and lifestyle interventions, including the limitations of fast food diets for the prevention of diabetes and weight control. Since obesity is considered to be an independent risk factor for the development of diabetes, addressing and managing it is of critical importance clinically. Targeted early interventions, including screening for risk factors, health promotion, and education activities, can aid in the adaptation of healthier lifestyles, which can reduce the burden of these diseases significantly.

Fusarium Keratitis: A Systematic Review (1969 to 2023).

BACKGROUND: Mycotic keratitis (MK) represents a corneal infection, with Fusarium species identified as the leading cause. Fusarium is a genus of filamentous fungi commonly found in soil and plants. While many Fusarium species are harmless, some can cause serious infections in humans and animals, particularly Fusarium keratitis, that can lead to severe ocular infections, prevalent cause of monocular blindness in tropical and subtropical regions of the world. Due to its incidence and importance in ophthalmology, we conducted a systematic analysis of clinical cases to increase our understanding of Fusarium keratitis by gathering clinical and demographic data. METHODS: To conduct an analysis of Fusarium keratitis, we looked through the literature from the databases PubMed, Embase, Lilacs, and Google Scholar and found 99 papers that, between March 1969 and September 2023, corresponded to 163 cases of Fusarium keratitis. RESULTS: Our analysis revealed the Fusarium solani species complex as the predominant isolate, with females disproportionately affected by Fusarium keratitis. Notably, contact lens usage emerged as a significant risk factor, implicated in nearly half of cases. Diagnosis primarily relied on culture, while treatment predominantly involved topical natamycin, amphotericin B, and/or voriconazole. Surprisingly, our findings demonstrated a prevalence of cases originating from the United States, suggesting potential underreporting and underestimation of this mycosis in tropical regions. This shows the imperative for heightened vigilance, particularly in underdeveloped regions with substantial agricultural activity, where Fusarium infections may be more prevalent than currently reported. CONCLUSION: Our study sheds light on the clinical complexities of Fusarium keratitis and emphasizes the need for further research and surveillance to effectively tackle this vision-threatening condition. Furthermore, a timely identification and early initiation of antifungal treatment appear to be as important as the choice of initial treatment itself.

Enhanced power grid performance through Gorilla Troops Algorithm-guided thyristor controlled series capacitors allocation.

This article introduces an innovative application of the Enhanced Gorilla Troops Algorithm (EGTA) in addressing engineering challenges related to the allocation of Thyristor Controlled Series Capacitors (TCSC) in power grids. Drawing inspiration from gorilla group behaviors, EGTA incorporates various methods, such as relocation to new areas, movement towards other gorillas, migration to specific locations, following the silverback, and engaging in competitive interactions for adult females. Enhancements to EGTA involve support for the exploitation and the exploration, respectively, through two additional strategies of periodic Tangent Flight Operator (TFO), and Fitness-based Crossover Strategy (FCS). The paper initially evaluates the effectiveness of EGTA by comparing it to the original GTA using numerical CEC 2017 single-objective benchmarks. Additionally, various recent optimizers are scrutinized. Subsequently, the suitability of the proposed EGTA for the allocation of TCSC apparatuses in transmission power systems is assessed through simulations on two IEEE power grids of 30 and 57 buses, employing various TCSC apparatus quantities. A comprehensive comparison is conducted between EGTA, GTA, and several other prevalent techniques in the literature for all applications. According to the average attained losses, the presented EGTA displays notable reductions in power losses for both the first and second systems when compared to the original GTA. Specifically, for the first system, the proposed EGTA achieves reductions of 1.659 %, 2.545 %, and 4.6 % when optimizing one, two, and three TCSC apparatuses, respectively. Similarly, in the second system, the suggested EGTA achieves reductions of 6.096 %, 7.107 %, and 4.62 %, respectively, when compared to the original GTA's findings considering one, two, and three TCSC apparatuses. The findings underscore the superior effectiveness and efficiency of the proposed EGTA over both the original GTA and several other contemporary systems.

A case report of metformin-associated lactic acidosis.

Key Clinical Message: Metformin-associated lactic acidosis is a rare but serious complication in patients with type 2 diabetes, especially those with multiple health conditions. Prompt recognition and treatment, including potential renal replacement therapy, are crucial for managing severe acidosis and improving patient outcomes. Abstract: Metformin (MTF) is commonly prescribed as a first-line treatment for diabetes, effectively preventing microvascular and macrovascular complications. However, metformin-associated lactic acidosis is a rare yet severe complication, associated with a mortality rate of up to 50%. We encountered a case involving a 73-year-old woman with type 2 diabetes, mental illness, and hypothyroidism, who developed life-threatening lactic acidosis while on metformin therapy. Upon presenting to the emergency department with complaints of weakness, nausea, and decreased urination for 5 days, she also reported abdominal pain and shortness of breath. Hypotension was noted with a blood pressure of 80/50 mmHg. Initial laboratory results revealed severe acidosis, prompting discontinuation of MTF. Despite resuscitation efforts and vasopressor therapy, severe acidemia persisted, leading to the initiation of renal replacement therapy. Following treatment with continuous renal replacement therapy, her acidemia resolved, and she was discharged from the hospital on the sixth day without complications, with normal kidney function.

RS-DFID Africa capacity-building initiative programme grant: harnessing unsteady phase-change heat exchange in high-performance concentrated solar power systems.

The Royal Society and UK Department for International Development supported a consortium of three universities across sub-Saharan Africa and Imperial College London with the aim of developing new knowledge on direct-steam-generation concentrated solar power (CSP) plants and supporting relevant capacity building across the Universities of Lagos, Mauritius and Pretoria. Key research findings from the programme include an improved flow-classification scheme for two-phase, liquid-liquid flows; testing of advanced surfaces with much-improved steady-state heat transfer performance-the commercial nanoFLUX surface showed up to 200% higher heat-transfer coefficients (HTCs) in pool boiling compared with other surfaces with R-134a/R-245fa; first-of-a-kind measurements of transient flow boiling HTCs, which were up to 30% lower in step perturbations than quasi-steady-state expectations in horizontal pipes with R-245fa; error estimation and corrections for laser-induced fluorescence (LIF) measurements, leading to the development of an adapted planar LIF technique with uncertainty <10% for local, instantaneous film thickness measurements in annular flows, and the application of such diagnostic methods to pool, falling-film and flow boiling in pipes; and predictions of an ~80% increase in the net present value of a case-study CSP plant when integrated with solid storage media.

Global citrus root microbiota unravels assembly cues and core members.

Introduction: Citrus is one of the most important fruit crops worldwide, and the root-associated microbiota can have a profound impact on tree health and growth. Methods: In a collaborative effort, the International Citrus Microbiome Consortium investigated the global citrus root microbiota with samples collected from nine citrus-producing countries across six continents. We analyzed 16S rDNA and ITS2 amplicon sequencing data to identify predominant prokaryotic and fungal taxa in citrus root samples. Comparative analyses were conducted between root-associated microbial communities and those from the corresponding rhizosphere and bulk soil samples. Additionally, genotype-based group-wise comparisons were performed to assess the impact of citrus genotype on root microbiota composition. Results: Ten predominant prokaryotic phyla, containing nine bacterial phyla including Proteobacteria, Actinobacteria, Acidobacteria, and Bacteroidetes and one archaeal phylum (Thaumarchaeota), and multiple fungal phyla including Ascomycota and Basidiomycota were identified in the citrus root samples. Compared with the microbial communities from the corresponding rhizosphere and bulk soil samples from the same trees, the prokaryotic and fungal communities in the roots exhibited lower diversity and complexity but greater modularity compared to those in the rhizosphere. In total, 30 root-enriched and 150 root-depleted genera in bacterial community were identified, whereas 21 fungal genera were enriched, and 147 fungal genera were depleted in the root niche compared with the rhizosphere. The citrus genotype significantly affected the root prokaryotic and fungal communities. In addition, we have identified the core root prokaryotic genera comprising Acidibacter, Allorhizobium, Bradyrhizobium, Chitinophaga, Cupriavidus, Devosia, Dongia, Niastella, Pseudomonas, Sphingobium, Steroidobacter and Streptomyces, and the core fungal genera including Acrocalymma, Cladosporium, Fusarium, Gibberella, Mortierella, Neocosmospora and Volutella. The potential functions of these core genera of root microbiota were predicted. Conclusion: Overall, this study provides new insights into the assembly of microbial communities and identifies core members of citrus root microbiota across a wide geographic range. The findings offer valuable information for manipulating root microbiota to enhance plant growth and health.

A Proliferating Trichilemmal Tumor at an Uncommon Site Treated With Radical Excision: A Case Report and Literature Review.

A proliferating trichilemmal tumor (PTT) is a rare, benign, exophytic tumor originating from the isthmus region of the outer root sheath of the hair follicle. Clinically, PTTs manifest as isolated, exophytic, firm nodules that have the potential to ulcerate. These tumors may occasionally originate from a pre-existing trichilemmal cyst, or they can emerge spontaneously. Most exclusively these lesions are seen on the scalp. However, rarely these tumors can be found in other anatomical areas. Our patient had a protruding mass in her shoulder for 20 years, and this is a rare site for the occurrence of these lesions; it could be the first case to document such a site, as far as we found in the literature. The mainstay treatment of the PTT is surgical excision of the tumor, assessing the histological margins to ensure sufficient resection was made, close monitoring, and follow-up with the patient.

Clinical Services, Barriers, and Public Perspectives of Community Pharmacies in Saudi Arabia: A Cross-Sectional Study.

In the Kingdom of Saudi Arabia, there is an increasing demand for community pharmacists to provide the highest level of clinical knowledge and services. However, evidence regarding Saudi public awareness of the clinical services offered by community pharmacies (CPs) and the barriers to using them is limited. In this cross-sectional study, we used an online questionnaire developed by adapting the Consolidated Framework for Implementation Research. A total of 273 participants completed the survey. Half the participants were generally aware of the availability of some CP services but were not informed about the full range on offer, eg, medication reviews (84%) and online counseling (89%). Most of the participants (69.6%) did not identify differences in the care provided by community pharmacists versus hospital pharmacists (P = 0.02). A commonly reported barrier to using CP services was a general preference for other healthcare professionals to seek pharmaceutical help (85.7%). Many other barriers were also reported, impacting the participants' use of these services. The decision-making authorities should consider improvements to increase patients' awareness and utilization of clinical services and enhance community pharmacists' performance in clinical-oriented pharmaceutical care.

The therapeutic efficacy of neem (Azadirecta indica) leaf extract against coinfection with Chlamydophila psittaci and low pathogenic avian influenza virus H9N2 in broiler chickens.

Avian chlamydiosis is a serious avian infection that carries a significant zoonotic danger to the poultry industry. The respiratory co-infections caused by the low pathogenic avian influenza virus H9N2 (LPAIV H9N2) also cause significant financial losses in the poultry industry. The purpose of this study was to examine the pathogenicity of Chlamydophila psittaci, and LPAIV H9N2 individually and in combination in broiler chickens, as well as to determine whether or not aqueous neem (Azadirachta indica) leaf extract is effective against infections caused by these pathogens. Therefore, 120 broiler cobb chicks were equally divided into 4 groups (30 birds each) with triplicates with 10 birds. Broilers in group 1 (G1) were infected with only C. psittaci, broilers in group 2 (G2) were infected with only LPAIV H9N2, broilers in group 3 (G3) were infected with C. psittaci and LPAIV H9N2, and broilers in group 4 (G4) remained not challenged and non-treated with any therapeutic or preventive treatment (negative control). At 21 d postinfection (dpi), birds in G1, G2, and G3 were divided into 3 subgroups of 10 birds each: subgroup (A) remained infected and untreated (positive control), subgroup (B) infected and received oxytetracycline for 5 consecutive d, and subgroup (C) infected and received 8% aqueous neem leaf extract for 5 consecutive d. The multiplication of C. psittaci in birds in G1, in various tissues was evaluated using Giemsa staining and the data showed that multiplication was much higher in the lung, spleen, and liver from 6 h to 21 dpi, but low in the heart from 8 to 21 dpi. During simultaneous co-infection in G3, the birds developed significant clinical symptoms and postmortem lesions (PM). Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect viral shedding from oropharyngeal and cloacal swabs between 2 dpi and 8 dpi, with cycle threshold (CT) values ranging from 22 to 24. In contrast, bacterial shedding began 6 h after infection and continued until 21 dpi, with CT values ranging from 23 to 26. Administration of an aqueous neem leaf extract at an 8% concentration (Group C) resulted in a numerical rise in average body weight across all treatment groups in the third and fourth week, as well as a reduction in LPAIV H9N2 and C. psittaci replication in the respiratory and gut of treated birds compared to those treated with oxytetracycline (Group B). Overall, respiratory co-infections pose a considerable risk to the poultry business, which is a big threat. To control C. psittaci and LPAIV H9N2 in broiler chickens, oral supplementation of 8% aqueous neem leaf extract is recommended. This treatment improves the birds' performance, as evidenced by an increase in their average body weight. In addition, the application of 8% aqueous neem leaf extract lowers C. psittaci replication within tissues and diminishes LPAIV H9N2 shedding.

Prevalence and associated factors of non-communicable chronic diseases among university academics in Jordan.

The increasing prevalence of non-communicable chronic diseases on a global, regional, and local scale demonstrates the extensive impact of these diseases, which now account for 70% of all worldwide deaths and affect a diverse population outside affluent places. The purpose of this study was to assess the prevalence and associated factors of non-communicable chronic diseases among academics at Mutah University in Jordan, while also taking into account the global trend of non-communicable diseases impacting different demographics. In a cross-sectional study, the majority of faculty members completed a questionnaire that included demographic information and prevalence of chronic diseases. The most prevalent conditions detected were hypertension (19.6%), diabetes mellitus (17.5%), rheumatoid arthritis (14.2%), heart disease (12.6%), and respiratory disorders (11.3%). Specifically, smoking and being overweight are underlined as significant risk factors, particularly among male respondents. These findings highlight the need of implementing health promotion programs in educational academic institutions, with an emphasis on fostering healthy dietary habits and encouraging physical activity.

Land use land cover and land surface temperature changes and their relationship with human modification in Islamabad Capital Territory, Pakistan.

Human activities are altering the existing patterns of Land Use Land Cover (LULC) and Land Surface Temperature (LST) on a global scale. However, long-term trends of LULC and LST are largely unknown in many remote mountain areas such as the Karakorum. . The objective of our study therefore was to evaluate the historical changes in land use and land cover (LULC) in an alpine environment located in Islamabad Capital Territory, Pakistan. We used Landsat satellite pictures (namely Landsat 5 TM and Landsat 8 OLI) from the years 1988, 2002, and 2016 and applied the Maximum Likelihood Classification (MLC) approach to categorize land use classes. Land Surface Temperatures (LST) were calculated using the thermal bands (6, 10, and 11) of Landsat series data. The correlation between the Human Modification Index (HMI) and LULC as well as LST was evaluated by utilizing data from Google Earth Engine (GEE). Over the study period, the urbanized area increased by 9.94%, whilst the agricultural and bare soil areas decreased by 3.81% and 3.94%, respectively. The findings revealed a significant change in the LULC with a decrease of 1.99% in vegetation. The highest LST class exhibited a progressive trend, with an increase from 12.27% to 48.48%. Based on the LST analysis, the built-up area shows the highest temperature, followed by the barren, agricultural, and vegetation categories. Similarly, the HMI for different LST categories indicates that higher LST categories have higher levels of human alteration compared to lower LST categories, with a strong correlation (R-value = 0.61) between HMI and LST. The findings can be utilized to promote sustainable urban management and for biodiversity conservation efforts. The work also has the potential of utilizing it to protect delicate ecosystems from human interference and to formulate strategies and regulations for sustainable urban growth, including aspects of land utilization and zoning, reduction of urban heat stress, and urban infrastructure.

Anomalous Electroluminescence Characteristics of Perovskite Modules.

Spatially resolved photoluminescence (PL) and electroluminescence (EL) imaging technologies play a crucial role in evaluating the performance and stability of photovoltaic devices. However, their application in perovskite devices presents unique challenges. In this study, we report a discrepancy between the electrical performance of perovskite solar modules (PSMs) and the EL images. Following the application of a reverse bias voltage, we observed an increase in EL brightness associated with prolonged carrier lifetime and transport length. Furthermore, cross-sectional Kelvin probe force microscopy identified a significant potential increase primarily at the electron-transport layer (ETL) side after reverse bias, suggesting the presence of defective ETL/perovskite interfaces with filled hole traps. To address this EL mismatch, we proposed a mild reverse current recovery method aimed at aligning EL images with the cell performance without compromising device efficiency. This approach effectively mitigates discrepancies, ensuring alignment between the device performance and EL imaging. Our study underscores that caution is required when utilizing EL imaging to monitor spatial homogeneity in PSMs for future industrial production.

Clinical outcomes in patients hospitalised with dysmagnesemia in the Northern Territory of Australia: a retrospective, longitudinal data-linkage study.

INTRODUCTION: Magnesium is an essential cation, and dysmagnesaemia is linked to many poor outcomes. This study aimed to assess the prevalence of dysmagnesaemia and associated health outcomes among hospitalised patients. METHODS: This register-based study collected demographic and laboratory data of hospitalised patients from five publicly funded hospitals in the Northern Territory, Australia, between 2008 and 2017. Patients were stratified into five groups based on their initial serum magnesium level at admission and followed up to death or 31 December 2017. RESULTS: A total of 22 293 patients were admitted during the study period. Dysmagnesaemia was present in 31.75% of hospitalised patients, with hypomagnesaemia being more common (29.62%) than hypermagnesaemia (2.13%). Hypomagnesaemia was more prevalent (43.13%) among the Australian First Nations Peoples. All levels of hypomagnesaemia were associated with a longer median length of hospital stay (p<0.001). Also, all levels of hypermagnesaemia were associated with a longer median stay in intensive care units (p<0.001). Patients with severe hypermagnesaemia had increased mortality compared to patients with severe hypomagnesaemia (56.0% v 38.0.0%, p<0.0001). Mortality was increased in both hypomagnesaemia (hazard ratio 1.86, 95% confidence intervaI 1.74-1.99, p<0.001) and hypermagnesaemia (1.78, 1.48-2.19, p<0.001) compared to normomagnesaemia. CONCLUSION: Dysmagnesaemia was prevalent among hospitalised patients and associated with increased mortality.

Anticoagulation activity of sulfated carboxymethyl cellulose/Azadirachta indica leaf powder-based bio-composite.

Polymeric bio-composites synthesized via a green approach using natural herbs have fascinating anticoagulant activity due to their eco-friendly and non-toxic behavior towards various physical and chemical actions. Herein, we introduce a simple and eco-friendly approach for the fabrication of a new hybrid type of bio-composite based on sulfated carboxymethyl cellulose (S-CMC) and Azadirachta indica leaf powder (S-CMC/NLP). First, a non-toxic sulfating agent called N(SO3Na)3 was used to modify carboxymethyl cellulose into S-CMC. With an ion exchange capacity of 0.25 meq. g-1, the level of sulfation (%) of S-CMC (modified polysaccharide) was measured to be 12.01%. Three types of S-CMC/NLP bio-composites were developed by varying the concentration of NLP. FE-SEM, EDX, and XRD were used to characterize the structural features of S-CMC/NLP bio-composites. FTIR spectroscopy indicated that the S-CMC/NLP bio-composite possesses COO-, -OH and SO3- groups, suggesting the structural similarity to heparin. In addition, the anticoagulant effect of the S-CMC/NLP bio-composite was investigated using PT and APTT assays. The APTT investigation confirmed that following the intrinsic pathway of the coagulation system, 2-NLP/S-CMC bio-composite dose-dependently (0.045-0.28 mg mL-1) prolonged the time of blood coagulation compared to control (pure plasma). The S-CMC/NLP bio-composite showed its potential as a new, safe, and effective candidate for anticoagulant activity.