Impact of various solutions on the oral health status of critically ill patients.

Oral care is a crucial challenge of nursing care in orally intubated patients. Oropharyngeal colonization with microorganisms is probably the first step in the pathogenesis of most bacterial pulmonary infections. This study aimed to investigate the effect of different oral care solutions on the oral health status of critically ill patients. We conducted a quasi-experimental study involving a convenience sample of 60 adult orally intubated patients, distributed equally into three groups: 20 patients received 0.12% chlorhexidine gluconate (CHX) solution as an oral rinse; 20 patients received 0.1% hexetidine (HEX) solution as an oral rinse; and a control group of 20 patients received routine hospital oral care with 0.9% normal saline (NS) solution. Oropharyngeal and tracheal cultures were obtained from patients within 24-48 h of admission, before the administration of topical oral antimicrobial solutions and then repeated on day 4 and day 7 after the oral solutions. The study revealed that CHX has a more powerful effect than HEX and NS in improving the oral mucosa and decreasing colonization of both the oropharynx and trachea. On day 7, the improvements were statistically significant in the CHX group and the HEX group (P = 0.02 and P = 0.03, respectively), but not in the NS group. This research confirms the effect of CHX and HEX in lowering the risk of tracheal and oropharyngeal colonization, and recommends the use of a CHX solution as oral mouth care in critically ill patients.

Prevalence of pressure injury on the medical wards of public general hospitals in Kuwait: a national cross-sectional study.

BACKGROUND: Pressure injury is a severe problem that can significantly impact a patient's health, quality of life, and healthcare expenses. The prevalence of pressure injuries is a widely used clinical indicator of patient safety and quality of care. This study aims to address the research gap that exists on this topic in Kuwait by investigating the prevalence of pressure injuries and preventive measures on the medical wards of the country's public general hospitals. METHODS: A cross-sectional research design was adopted to measure the point prevalence of pressure injuries on 54 medical wards in the public general hospitals. Data, including variables pertaining to hospitals, patients, pressure injuries and preventive practices, were collected using an online form. The data were processed and analysed using Microsoft Excel and SPSS 23 (α level = 0.05). Analysis provided an overview of patient, pressure injury characteristics and preventive measures, and the relationships between the patient and pressure injury characteristics and the prevalence of pressure injuries. A model for predicting the determinants of pressure injury prevalence was constructed from a linear regression analysis. RESULTS: The mean national prevalence of pressure injury was 17.6% (95% CI: 11.3-23.8). Purely community-acquired pressure injuries represent the majority of pressure injuries nationally (58.1%). Regarding preventive measures, "pressure injury assessment on admission" has been provided to 65.5% of patients. Correlation analysis revealed that the only statistically significant correlation with the prevalence of hospital-acquired pressure injury was "pressure injury assessment on admission", which was strongly negative (ρ = -0.857). Therefore, this was the only variable included in the regression analysis as a predictor of pressure injury prevalence (Beta = 0.839). The results showed many statistically significant differences between hospitals with respect to the variables studied. CONCLUSIONS: The national pressure injury prevalence is high compared to the global rate. The higher percentage of purely community-acquired pressure injuries requires particular attention. Many risk factors for the development of pressure injuries are public health concerns, and effective mitigating strategies are needed. Further research is required to assess the knowledge, attitude, and behaviour of nurses with respect to pressure injuries, and to evaluate preventive and management practices.

High-performance photocatalytic degradation and antifungal activity of chromium-doped nickel oxide nanoparticles.

The elimination of pollutants such as dyes and fungi has become a tedious process hence there is a need for multifunctional materials that can be used for the removal or degradation of various pollutants from wastewater. Here, a nickel oxide nanoparticle (NiONPs) was synthesized by the co-precipitation method. In the current study, a composite of nickel oxide nanoparticles (NiONPs) was synthesized using nitrogen and chromium as dopants to create (N/NiONPs) and (Cr/N/NiONPs), respectively and used for the removal of dyes and fungi. The synthesized nanocomposites were characterized using zeta potential (ZP), scanning electron microscopy (SEM), X-rays diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR). The NiONPs, N/NiONPs and Cr/N/NiONPs were tested for the degradation of two dye pollutants, Reactive blue 13 (RB13) and eosin dye. The obtained results showed that Cr/N/NiONPs were more efficient than NiONPs and N/NiONPs for dye degradation by applying the same irradiation conditions. The Cr/N/NiONPs nanocomposites showed very good degradation efficiency of dye up to 94.2% for the RB13 and 90.8% for the eosin. We also examined the antifungal action of the NiONPs, N/NiONPs and Cr/N/NiONPs against Trichoderma fungus. The results showed that the Cr/N/NiONPs have an extremely strong antifungal impact on Trichoderma. This could be explained by the strong adhesion of Cr/N/NiONPs to the Trichoderma surface due to electrostatic attraction. This work has demonstrated that it is possible to create environmentally safe materials that can be used for the degradation of different dyes and the improvement of more effective antifungal treatments with lower active agent doses for fungus control with potential big economic benefits.

Effect of Intralesional Sodium Stibogluconate Alone versus Combinations with Topical Trichloroacetic Acid 50% or Fractional Carbon Dioxide Laser on Cutaneous Leishmaniasis.

Background: Cutaneous leishmaniasis (CL) is a vector-borne protozoal disease. Antimonial drugs remain the first-line treatment for CL despite the widespread drug resistance and high incidence of side effects. The present study aimed to compare the efficacy and safety of traditional intralesional sodium stibogluconate (SSG) alone and its combinations with trichloroacetic acid (TCA) 50% and fractional carbon dioxide (CO2) laser for the treatment of CL. Materials and Methods: An interventional study was carried out on 25 CL patients. In each patient, three lesions were assigned to treatment either by SSG alone (GI), SSG plus TCA 50% (GII), or SSG plus fractional CO2 laser (GIII). The overall clinical improvement and changes in the sizes of lesions and scars were assessed and compared among the three groups. Results: GIII patients had significantly lower treatment sessions as compared to GI patients (3.6 ± 1.29 versus 4.04 ± 2.11, P = 0.042). Moreover, GII and GIII patients had significantly shorter healing times when compared with GI (3.63 ± 1.35 and 3.46 ± 1.25, respectively, versus 4.0 ± 2.15 weeks, P = 0.019). Also, it was shown that GIII patients had significantly lower scar scores (1.40 ± 1.52) when compared with GI (3.00 ± 0.0) and GII (2.80 ± 1.10), P = 0.017. Conclusions: Intralesional SSG with TCA 50% is more effective than SSG alone and is comparable to SSG and fractional CO2 combination in the treatment of CL with better safety profile and patient satisfaction.

Impact of Nurse Leaders Behaviors on Nursing Staff Performance: A Systematic Review of Literature.

Nursing leadership is critical in facilitating and improving nurse performance, which is essential for providing quality care and ensuring patient safety. The aim of this study is to explore the relationship between nursing leadership and nurse performance by understanding the leadership behaviors and factors that motivate nurses to perform well. To study the factors that nurses believe motivate them to perform better, a systematic review was undertaken, correlating these factors to leadership behaviors/styles. The PRISMA guidelines were followed to identify relevant articles. After applying the selection criteria, 11 articles were included in the final analysis. Overall, 51 elements that influence nurses' motivation to perform better were found and categorized into 6 categories, including autonomy, competencies, relatedness, individual nursing characteristics, relationships and support, and leadership styles/practices. It has been discovered that both direct and indirect nursing leadership behaviors affect nurses' performance. A better understanding of the factors that motivate nurses to perform well and facilitating them in the work environment through leadership behaviors/styles can improve nurses' performance. There is a need to increase research on nurse leadership and nurses' performance in the current innovative and technologically integrated work environment to identify new factors of influence.

Facile Synthesis of NiO-CuO/Activated Carbon Nanocomposites for Use in the Removal of Lead and Cadmium Ions from Water.

In this work, activated carbon (AC) was synthesized and then modified using nickel(II) oxide and copper(II) oxide. Pure-AC, 10, 20, 30, and 40 wt % nanohybrid NiO-CuO/AC nanocomposites (χ-NC/AC NCs) were characterized using XRD, IR, EDS, surface area, and FE-SEM techniques. Furthermore, the adsorbents obtained were tested for their ability to remove hazardous Pb(II) and Cd(II) from water. The fabricated x-NC/AC NC adsorbents showed the highest adsorptive performance toward the adsorption of Pb(II) and Cd(II) from water. The 30-NC/AC NC adsorbent showed the complete removal of Pb(II) at pH = 5 and Cd(II) at pH = 7 within 30 min. Overall, the obtained superior experimental results suggest that the adsorptive performance of AC was greatly enhanced after loading hybrid metal oxide nanoparticles, so its application in water treatment is potential and applicable.

Barometric and Spatiotemporal Gait Differences Between Leading and Nonleading Feet of Handball Players.

BACKGROUND: Side-to-side stress imbalance has been suggested as a risk factor for injury in unilateral sports. The leading leg is suggested to be essential in sports rehabilitation for the return of athletes to the playground. The main aim of this study was to evaluate the dynamic pedobarometric and spatiotemporal gait differences between the leading and nonleading feet of male handball players. METHODS: Thirty healthy elite male handball players (mean ± SD: age, 31.7 ± 2.99 years; height, 177.5 ± 6.0 cm; weight, 78.9 ± 6.3 kg; body mass index, 25.0 ± 0.7) participated in this study; all of the participants were backcourt and pivot handball players. The assessments were performed using the Tekscan Walkway pressure sensor to detect and compare the variables of interest between the leading and nonleading feet during normal walking at a self-selected speed. RESULTS: Maximum force, peak pressure (total and forefoot pressure), foot width, single-limb support time, and step velocity were significantly increased in the leading foot compared with the nonleading foot. In addition, maximum force, foot width, and total peak pressure showed moderate positive significant correlations with body mass index. CONCLUSIONS: The differences in the pedobarometric and spatiotemporal gait parameters may result from the physiologic and mechanical demands that are put on the leading foot of handball players, which need more rehabilitation attention and protection to avoid expected injuries.

Ameliorative effects of Dictyota dichotoma on hepatotoxicity induced by gibberellic acid in albino rats.

Gibberellic acid (GA3) is a natural plant growth regulator that is crucial for plant structural and functional development. We examined the alleviating capacity of brown algae (Dictyota dichotoma) on biochemical and molecular degenerative processes caused by sub-chronic exposure to gibberellic acid resulting in hepatic cell apoptosis. Adult male albino rats were divided into five equal groups: the first group received distilled water, the second group was treated with GA3, the third group was administered D. dichotoma extract suspended in 1% carboxymethylcellulose (CMC), the fourth group was administered both GA3 and D. dichotoma simultaneously, and the fifth group received 1% CMC orally, 5 days per week for a total of 50 days. The results indicated that GA3 induced a significant increase in liver function parameters based on serum levels of alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin, which indicate hepatotoxicity. A marked increase in malondialdehyde (MDA) levels and a marked decrease in reduced glutathione (GSH), glutathione-S-transferase (GST), and superoxide dismutase (SOD) were observed as a result of induction of lipid peroxidation and oxidative stress. Histopathology revealed severely degenerated hepatocytes including cytoplasmic vacuolations and many apoptotic cells with weak Bcl2 expression. Similarly, there was a significant up-regulation of gene and protein expression levels for the pro-apoptotic markers, Caspase-3 and Bax, and an increase in pro-inflammatory marker levels, tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) as well as C-reactive protein (CRP). The co-administration of D. dichotoma restored the disrupted biochemical, histopathological, molecular, and inflammatory changes resulting from GA3 toxicity. Our results confirm the antioxidant, anti-inflammatory, anti-apoptotic, and hepatoprotective potential of D. dichotoma.

Effectiveness of Standardized Protocol for Oxygen Therapy on Improving Nurses' Performance and Patients' Health Outcome.

AIMS: assess nurses' knowledge and performance-related safe administration of oxygen (O2) therapy; apply an intervention program for nurses about standardized protocol for oxygen; and evaluate the effectiveness of standardized protocol for oxygen in improving nurses' performance and patients' health outcomes. DESIGN: a quasi-experimental study was used. SETTING: the current study was conducted at three hospitals in Sakaka City with totally different medical aid units (ICUs), CCUs, emergency care departments (ED), medical and surgical wards, pediatric care units (PICUs), neonatal intensive care units (NICUs), pediatric emergency care departments (PED) and pediatric inpatient\outpatient departments. SUBJECTS: a convenience sample of 105 nurses and 105 patients was divided into 55 patients in the control group who received routine care and 50 patients in the study group who received intervention. FINDINGS: 34.3% of studied nurses had poor knowledge pre-intervention compared with 17% post-intervention. Moreover, 33.3% of them had satisfactory knowledge pre-intervention versus 21% post-intervention. Only 5.7% of them had excellent knowledge pre-intervention, compared with 34.4% post-intervention. Concerning the complications of oxygen therapy, only 10.5% did not have complications in the control group versus 62.9% in the study group, 33.3% of the control group had cyanotic lips and fingernails pre-intervention, versus 7.6% in the study group; 10.5% had oxygen toxicity in the control group, versus 7.6% in the study group, with a highly statistically significant difference at p 0.001 for all. CONCLUSION: the current results of this study concluded that there was improvement in nurses' knowledge and practice related to oxygen therapy post-intervention. Moreover, when the standard protocol for safe oxygen therapy was used in a positive way, it led to better health for patients and fewer problems with oxygen therapy.

An Association Between Blastocystis Subtypes and Colorectal Cancer Patients: A Significant Different Profile from Non-cancer Individuals.

PURPOSE: Blastocystis is a common enteric human parasite of non-conclusive pathogenicity which may be determined by subtype (ST) variation. Colorectal cancer (CRC) is considered one of the primary causes of cancer mortality. Blastocystis ST7 has been shown to reduce beneficial intestinal microbiota and may exacerbate CRC. This study assessed the possible association between Blastocystis STs and CRC in comparison to non-cancer patients. MATERIAL AND METHODS: A total of 200 fecal samples were obtained from CRC (100) and non-CRC (100) individuals attending Beni-Suef University Hospital, Egypt. Blastocystis was searched for in all samples using microscopy and culturing. Positive subculture samples were genetically sequenced and subtyped using conventional polymerase chain reaction (PCR). Blastocystis STs were determined by sequencing and a phylogenetic tree was created. Related patient characteristics and tumor stages were analyzed for association with presence of Blastocystis. RESULTS: Blastocystis was identified in 52% and 42% of CRC and non-cancer individuals, respectively. ST1, 2, and 3 were isolated from both cancer and non-cancer individuals; however, for the first time, ST7 was only isolated from CRC stool samples with significant association. Associated patient characteristics were evaluated as predictors. CONCLUSION: Blastocystosis is highly prevalent in CRC patients, predominantly in the latest CRC grades and stages. To the best of our knowledge, this is the first study to report the identification of Blastocystis ST7 in CRC patients. To determine whether certain STs of Blastocystis are associated with CRC would require further research, including the role played by gut microbiota.

Exploring the Psychological Stress, Anxiety Factors, and Coping Mechanisms of Critical Care Unit Nurses During the COVID-19 Outbreak in Saudi Arabia.

Background: The spread of coronavirus disease 2019 (COVID-19) throughout the world leads to a series of modifications of several National Health Service organizations, with a potential series of psychological consequences among nurses. Methods: This study was undertaken to assess the psychological stress, anxiety factors, and coping mechanisms of critical care unit nurses during the COVID-19 outbreak. A cross-sectional research design was employed, and the convenience sample consisted of 469 nurses working at several hospitals in Saudi Arabia during the period from July to September 2020. This study used the Generalized Anxiety Disorder, Coping Mechanism, and Nursing Stress scale. Results: Interestingly, more than one-third and one-quarter of the studied nurses had severe and moderate anxiety levels, respectively. In addition, the most anxiety-causing factors included providing care for their infected colleagues and worrying about infecting their families. More than one-quarter and slightly less than half of the studied nurses had high and moderate stress levels, respectively. Furthermore, more than half of the participants had low coping mechanisms and one-quarter had moderate coping mechanisms. In addition, there was a strong positive correlation between anxiety and stress levels, and there was a strong negative correlation between coping mechanisms and stress and anxiety levels. Conclusions: Collectively, this study explored the psychological stress, anxiety factors, and coping mechanisms among critical care unit nurses during the COVID-19 outbreak in Saudi Arabia. Continuous educational programs for nurses on using coping mechanisms should be developed in combination with teaching preventive measures for defining a psychological intervention plan within a mandatory occupational health surveillance program. This study recommends that constructive planning and necessary provision of supportive measures by the legal authorities and policymakers protect nurses and minimize their psychological stress to fulfill high-quality nursing care.

Potential impacts of Acu-TENS in the treatment of adolescents with moderate to severe bronchial asthma: A randomized clinical study.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of transcutaneous electrical nerve stimulation over the acupuncture points (Acu-TENS) on total serum immunoglobulin E (IgEtotal), pulmonary function, and quality of life in adolescents with asthma. METHODS: In a double-blind randomized clinical trial, 32 adolescents (age; 12-16 years) with asthma participated and were assigned randomly to receive either the breathing retraining program (control group) or the breathing retraining program plus Acu-TENS application (Acu-TENS group). Acu-TENS was applied for 40 min' day-after-day session for two successive months, with no side-effects reported. Serum IgEtotal, pulmonary function [forced vital capacity (FVC), forced expiratory volume at one second (FEV1), and FEV1/FVC], and quality of life were evaluated pre- and post-treatment. RESULTS: Serum IgEtotal (P = 0.028, ηp2 = 0.15), Pulmonary function [FVC (P = 0.043, ηp2 = 0.13), FEV1 (P = .046, ηp2 = 0.12)], and quality of life (P < .001, ηp2 = 0.17) increased significantly in the Acu-TENS group when compared to the control group. CONCLUSION: This study demonstrates that the Acu-TENS is an impending asthma treatment that may be used to reinforce the immune system response, ameliorate lung function, and increase the quality of life in adolescents with asthma.

Green construction of eco-friendly phosphotungstic acid Sr-MOF catalysts for crystal violet removal and synthesis of coumarin and xanthene compounds.

There is an urgent need to improve engineering and synthetic chemistry, either through the use of eco-friendly starting materials or the proper design of novel synthesis routes. This reduces the contamination of toxic chemicals and helps the disposal of organic dyes. In the current work, a metal-organic framework-based Sr(ii) was fabricated to achieve the desired goal for dye removal and catalysis. Sr-MOF-based phosphotungstic acid (PWA/Sr-MOF) was hydrothermally synthesized to study its adsorption and catalytic activities. Remarkably, about 99.9% of crystal violet (CV) dye was removed using PWA/Sr-MOF within 90 min at room temperature. Various factors have been studied to investigate the optimum conditions such as pH of solution, initial dye concentration, contact time, and temperature. The maximum adsorption capacity of CV dye was reached after 90 min and well fitted the pseudo-second kinetic order and Langmuir adsorption isotherm. Coumarin and xanthene reactions were chosen to test the catalytic activity of the prepared PWA/Sr-MOF at 373 K. Furthermore, structural and chemical characterization of the fabricated samples was obtained using FT-IR, XRD, TGA, DTA, TEM, EDX, and XPS. PWA/Sr-MOF can be considered as a promising and green framework in the material design used to study catalytic and adsorption performances.

Mac-2 binding protein in non-alcoholic fatty liver disease: Is it a reliable diagnostic biomarker? A pilot study.

AIM OF THE STUDY: This study aimed to assess the level of serum Mac-2 binding protein (Mac-2BP) as a non-invasive biomarker for the diagnosis of non-alcoholic fatty liver disease (NAFLD). MATERIAL AND METHODS: Forty patients with NAFLD and 15 healthy sex- and age-matched subjects were included in this pilot study. Serum Mac-2BP level was measured using ELISA. Liver biopsy was taken from 20 patients. RESULTS: There was no statistically significant difference between patients and controls regarding the level of Mac-2BP (p = 0.209). Mac-2BP had a statistically significant correlation with the grade of lobular inflammation (r = 0.464, p = 0.039). The Mac-2BP cut-off value used for NASH prediction was 9.55 µg/ml, with sensitivity and specificity of 100% and 91.7%, respectively. CONCLUSIONS: This study showed that Mac-2BP is not elevated in NAFLD patients compared to controls. It also demonstrated that the reliability of Mac-2BP as a biomarker for NAFLD diagnosis is still controversial and needs more investigation.

Escherichia coli inactivation using a hybrid ultrasonic-electrocoagulation reactor.

In the current study, a new hybrid ultrasonic-electrocoagulation reactor (U-E reactor) has been used to inactivate Escherichia coli in water. The new hybrid reactor consists of an ultrasonic bath fitted with four perforated aluminium electrodes. These perforated electrodes are designed to act as baffle-plates to enhance the water-mixing process. The electrodes eliminate the need for external mixing devices, which in turn, enhances the cost-effectiveness of the unit. Initially, the ability of the electrocoagulation to inactivate E. coli was optimised for different operating parameters such as electrolysing time (Te), electrodes spacing (ES) and current density (CD). The ultrasonic field was then applied over different time periods (Tu), during the course of the electrolysing process. Statistical analyses have been conducted to assess the relative effect of each operating parameter on the inactivation of E. coli. An economic study has also been conducted to assess the operating costs of the U-E reactor. The results revealed that the new U-E reactor inactivated 100% of the E. coli within 11 min of electrolysis at ES of 5 mm, CD of 1.5 mA/cm2, and an operation cost of 0.212 US $/m3. It was been established that the relative effect of operating parameters on E.coli inactivation followed the order: Te>Tu>CD>ES.

New Insights Into Potential Benefits of Bioactive Compounds of Bee Products on COVID-19: A Review and Assessment of Recent Research.

The recent emergence of COVID-19 represents one of the biggest challenges facing the world today. Despite the recent attempts to understand the epidemiological pattern and pathogenesis of the disease, detailed data about the physiology and pathology of the disease is still out of reach. Moreover, the lack of a widespread vaccine prompts an urgent call for developing a proper intervention strategy against the virus. Importantly, identification of novel molecules that target replication of the virus represents one of the promising strategies for the control this pandemic crisis. Among others, honey bee products contain numerous bioactive compounds such as propolis and several phenolic compounds that possess a wide range of therapeutic properties for combating various pathological disorders and infectious agents. The intention of the present review is to highlight the stages of SARS-CoV-2 lifecycle, the molecular mechanisms explaining the health benefits of honey bee products on COVID-19 physiology and pathology and the possible limitations. Further future research is suggested to explore more about bee natural bioactive compounds as potential candidates against SARS-CoV-2.