COVID-19 surveillance report for Sudan, 2020 to 2021.

Background: Following the World Health Organization declaration, COVID-19 was first appearance in Sudan was in March 2020. Cases were reported to the Sudan Federal Ministry of Heath through the surveillance system from different sources. This study used surveillance data from 2020 to 2021 to describe the epidemiologic patterns of COVID-19 occurrence in Sudan and provide insight for better preparedness and response. Methods: Through a retrospective descriptive study, COVID19 cases records obtained from the national surveillance line-list in Surveillance and Information Directorate in Federal Ministry of Health. The analysis of data was done with SPSS version 21. Descriptive analysis done by frequencies and percentages, and further analysis through performing multivariate logistic regression. Results: Out of 48,545 suspected cases tested for COVID-19 using RT-PCR, 27,453 (56.5%) tested positive with case fatality ratio of 6.5%. Higher death rate among elderly (78% > 60-year-old) and males (70.1%). From the reported cases, 53.8% showed no symptoms, while the common symptoms among symptomatic patients were; fever (26.4%), cough (19.1%), shortness of breath (16.8%) with small proportion (4.5%) reported loss of smell and taste. Specific states, Khartoum, Gezira and Red Sea showed highest prevalence. The disease peaked four times during 2020-2021, with a proposed alert threshold of 200-250 cases per week acting as an explosion point nationwide. Conclusions: The high case fatality rate in the country requires further analysis, as well as the high proportion of asymptomatic infection. This will be ensured by improving the quality and completeness of surveillance data. A proposed threshold of 200-250 cases per week should be an alert to augment the measures of controlling the pandemic over the country, including providing enough supplies to decrease mortality.

Lessons Learned from the Pandemic in the UAE: Children COVID-19 Vaccine Hesitancy and Its Impact on the Choice of Distance versus Face-to-Face Learning Modalities: An In-Depth Analysis of a National Study.

This study addresses the crucial aspect of childhood COVID-19 vaccination and its impact on parental decisions concerning learning modalities during the pandemic. This study aimed to gauge parental hesitancy towards vaccinating their children and its influence on choosing between distance and face-to-face learning options. Following STROBE guidelines for cross-sectional studies, this study surveyed 1973 parents in the United Arab Emirates using Google Forms during the COVID-19 pandemic. The results revealed that while more than half of the parents (51.6%) were willing to vaccinate their children if the COVID-19 vaccine was accessible and affordable, a significant majority (91.2%) expressed concerns about the rapid vaccine development process, which was the primary reason for vaccine rejection. Interestingly, a sizable portion (55.3%) had experienced online learning in the previous academic term, and, of those, 59.6% believed it negatively influenced their children's academic performance. Consequently, 66.4% expressed intent to shift their children back to face-to-face learning once feasible. Significantly, parents with medical backgrounds were more inclined (91.6%) to opt for face-to-face schooling compared to those without such backgrounds. Logistic regression analysis indicated associations between sociodemographic characteristics, educational level and background, and the decision to return children to face-to-face learning. Interestingly, when it comes to vaccine hesitancy, a noteworthy connection exists between the parents' reluctance to vaccinate their children and their preference for distance learning. In fact, parents who responded negatively to vaccinating their children against COVID-19, if the vaccine was available, showed a clear preference for the distance learning modality (p-value < 0.0001). This study underscores the complex interplay of factors and community perspectives shaping parental acceptance of childhood COVID-19 vaccination. The development pace of vaccines significantly influences parents' attitudes and beliefs about vaccination programs. Parents' medical backgrounds exhibit a clear correlation with their perceptions of sending children back to school safely. This highlights the potential impact of parental medical knowledge on decision making, emphasizing the need to consider parents' professional backgrounds when devising education- and vaccination-related policies.

Innovative antibacterial electrospun nanofibers mats depending on piezoelectric generation.

This paper introduces a new approach of testing piezoelectric nanofibers as antibacterial mat. In this work, both Polyvinylidene fluoride (PVDF) and PVDF embedded with thermoplastic polyurethane nanofibers are synthesized as nanofibers mat via electrospinning technique. Then, such mat is analyzed as piezoelectric material to generate electric voltage under different mechanical excitations. Furthermore, morphological and chemical characteristics have been operated to prove the existence of beta sheets piezoelectricity of the synthesized nanofibers mats. Then, the synthesized nanofibers surfaces have been cyclically stretched and exposed to bacteria specimen. It has been noticed that the generated voltage and the corresponding localized electric field positively affect the growth of bacteria and reduces the formation of K. penomenue samples bacteria colonies. In addition, the effect of both stretching frequency and pulses numbers have been studied on the bacteria count, growth kinetics, and protein leakage. Our contribution here is to introduce an innovative way of the direct impact of the generated electric field from piezoelectric nanofibers on the reduction of bacteria growth, without depending on traditional anti-bacterial nanoparticles. This work can open a new trend of the usability of piezoelectric nanofibers through masks, filters, and wound curing mats within anti-bacterial biological applications.

Parents' Perception, Acceptance, and Hesitancy to Vaccinate Their Children against COVID-19: Results from a National Study in the UAE.

Introduction: COVID-19 is considered the greatest health disaster affecting humans during the 21st century, which urged the need to develop an effective vaccine to acquire enough immunity against the virus. The main challenge faced during the development of such vaccines was the insufficiency of time, which raised the question about the vaccine safety and efficacy, especially among children. Parents' and caregivers' thoughts and acceptance of administering the vaccine to their children are still debatable topics and are yet to be explored in the UAE. Aims: The study aims to exploit parent acceptance, perception, and hesitancy toward the COVID-19 vaccine administration for their children and the link with their choice of distance learning instead of face-to-face education in the UAE. Methodology: This study utilized a cross-sectional descriptive design. A sample of 1049 parents across all emirates were conveniently approached and surveyed using Google forms from June to September 2021. The participants responded to a semi-structured questionnaire pertaining to socio-demographic, educational, and other questions related to COVID-19 and its link with their beliefs in whether the vaccination of their children will help with resuming face-to-face learning. Results: Approximately 74% of the parents confirmed that their children who are 16 years old and above have received the vaccine, and 71% were willing to give the vaccine to their children aged above 5 years. Parents with children receiving online education and those with children where the online modality of learning negatively affected their academic achievement are more prone to administer the COVID-19 vaccine to their children above five years old. The results show a significant association between vaccination of children and the parental desire for resuming physical attendance in schools (p value < 0.001). Multivariate analysis showed that the highest acceptance rate was from parents with children of low academic achievement due to online learning modality during the pandemic. Conclusion: In the UAE, parents of young children have shown a positive attitude towards COVID-19 vaccination in belief that vaccines will reduce the risk of infection and assist in resuming normal lifestyles, such as going back physically to schools. The results reflect the public awareness and the hypervigilance regarding the COVID-19 pandemic in the UAE.

Protocol for systematic review and meta-analysis of randomized controlled trials, cost-benefit analysis and interrupted timeseries interventions on pharmacist’s prescribing

Background: Shortening the process of prescribing via permitting the pharmacist to select the most appropriate pharmaceuticals for each particular patient may provide great opportunities for pharmacists to develop suitable pharmaceutical care plan, monitor and follow up prescribed medications, communicate and consult physicians for more confirmations. Objective: The objective of the current protocol for the systematic review and meta-analysis of pharmacists prescribing interventions was to explore, investigate the evidence, assess and compare PICO in patients with medical conditions (population), receiving pharmacist’s prescribing care services (interventions) versus non-pharmacist’s prescribing (comparators), and identify how it will impact the clinical, humanistic, and economic patient’s outcomes (outcomes). Methods: The necessary elements of PRISMA will be strictly followed to report the systematic review. The meta-analysis will be reported in line with the Cochrane guidelines for synthesis of trials and all forms will be based on quality measures as per the validated Cochrane templates. We will present the results of the systematic review and the meta-analysis based on PICO comparison between the included trials. Results: We have identified four models of pharmacist prescribing interventions (independent, dependent [collaborative], supplementary, and emergency prescribing). The results will contain a systematic critical evaluation of the included trials in terms of the sample number of the population (characteristics), the type of interventions and the comparators, and the main outcome measures. Conclusion: This protocol will report the evidence and explore the magnitude of impact of pharmacist prescribing interventions, on clinical, humanistic, and economic outcomes. (AU)

Protocol for systematic review and meta-analysis of randomized controlled trials, cost-benefit analysis and interrupted time-series interventions on pharmacist's prescribing.

Background: Shortening the process of prescribing via permitting the pharmacist to select the most appropriate pharmaceuticals for each particular patient may provide great opportunities for pharmacists to develop suitable pharmaceutical care plan, monitor and follow up prescribed medications, communicate and consult physicians for more confirmations. Objective: The objective of the current protocol for the systematic review and meta-analysis of pharmacists prescribing interventions was to explore, investigate the evidence, assess and compare PICO in patients with medical conditions (population), receiving pharmacist's prescribing care services (interventions) versus non-pharmacist's prescribing (comparators), and identify how it will impact the clinical, humanistic, and economic patient's outcomes (outcomes). Methods: The necessary elements of PRISMA will be strictly followed to report the systematic review. The meta-analysis will be reported in line with the Cochrane guidelines for synthesis of trials and all forms will be based on quality measures as per the validated Cochrane templates. We will present the results of the systematic review and the meta-analysis based on PICO comparison between the included trials. Results: We have identified four models of pharmacist prescribing interventions (independent, dependent [collaborative], supplementary, and emergency prescribing). The results will contain a systematic critical evaluation of the included trials in terms of the sample number of the population (characteristics), the type of interventions and the comparators, and the main outcome measures. Conclusion: This protocol will report the evidence and explore the magnitude of impact of pharmacist prescribing interventions, on clinical, humanistic, and economic outcomes. .

Comprehensive Wet-Bench and Bioinformatics Workflow for Complex Microbiota Using Oxford Nanopore Technologies.

The advent of high-throughput sequencing techniques has recently provided an astonishing insight into the composition and function of the human microbiome. Next-generation sequencing (NGS) has become the gold standard for advanced microbiome analysis; however, 3rd generation real-time sequencing, such as Oxford Nanopore Technologies (ONT), enables rapid sequencing from several kilobases to >2 Mb with high resolution. Despite the wide availability and the enormous potential for clinical and translational applications, ONT is poorly standardized in terms of sampling and storage conditions, DNA extraction, library creation, and bioinformatic classification. Here, we present a comprehensive analysis pipeline with sampling, storage, DNA extraction, library preparation, and bioinformatic evaluation for complex microbiomes sequenced with ONT. Our findings from buccal and rectal swabs and DNA extraction experiments indicate that methods that were approved for NGS microbiome analysis cannot be simply adapted to ONT. We recommend using swabs and DNA extractions protocols with extended washing steps. Both 16S rRNA and metagenomic sequencing achieved reliable and reproducible results. Our benchmarking experiments reveal thresholds for analysis parameters that achieved excellent precision, recall, and area under the precision recall values and is superior to existing classifiers (Kraken2, Kaiju, and MetaMaps). Hence, our workflow provides an experimental and bioinformatic pipeline to perform a highly accurate analysis of complex microbial structures from buccal and rectal swabs. IMPORTANCE Advanced microbiome analysis relies on sequencing of short DNA fragments from microorganisms like bacteria, fungi, and viruses. More recently, long fragment DNA sequencing of 3rd generation sequencing has gained increasing importance and can be rapidly conducted within a few hours due to its potential real-time sequencing. However, the analysis and correct identification of the microbiome relies on a multitude of factors, such as the method of sampling, DNA extraction, sequencing, and bioinformatic analysis. Scientists have used different protocols in the past that do not allow us to compare results across different studies and research fields. Here, we provide a comprehensive workflow from DNA extraction, sequencing, and bioinformatic workflow that allows rapid and accurate analysis of human buccal and rectal swabs with reproducible protocols. This workflow can be readily applied by many scientists from various research fields that aim to use long-fragment microbiome sequencing.

Antibacterial Synergism of Electrospun Nanofiber Mats Functioned with Silver Nanoparticles and Pulsed Electromagnetic Waves.

The over-reliance on antibiotics and their enormous misuse has led to warnings of a future without effective medicines and so, the need for alternatives to antibiotics has become a must. Non-traditional antibacterial treatment was performed by using an aray of nanocomposites synergised with exposure to electromagnetic waves. In this manuscript, electrospun poly(vinyl alcohol) (PVA) nanofiber mats embedded with silver nanoparticles (Ag NPs) were synthesized. The nanocomposites were characterized by Transmission Electron Microscope (TEM), Scanning Electron Microscope (SEM), Current-Voltage (I-V) curves, and Thermogravimetric analysis (TGA) along with analysis of antibacterial impact against E. coli and S. aureus bacteria, studied by bacterial growing analysis, growth kinetics, and cellular cytotoxicity. The results indicated a spherical grain shape of silver of average size 20 nm and nanofibers' mean diameter of less than 100 nm. The nanocomposite mats showed good exposure to bacteria and the ability to sustain release of silver for a relatively long time. Moreover, the applied electromagnetic waves (EMWs) were shown to be a synergistic co-factor in killing bacteria even at low concentrations of Ag NPs. This caused pronounced alterations of the bacterial preserved packing of the cell membrane. Thereby, the treatment with nanocomposite mats under EM wave exposure elucidated maximum inhibition for both bacterial strains. It was concluded that the functioning of nanofiber with silver nanoparticles and exposure to electromagnetic waves improved the antibacterial impact compared to each one alone.

Surface modified of polyacrylonitrile nanofibers by TiO2/MWCNT for photodegradation of organic dyes and pharmaceutical drugs under visible light irradiation.

This work describes the fabrication of two composite nanofibers systems containing polyacrylonitrile polymer (PAN), Multiwall carbon nanotubes (MWCNT) and Titania (TiO2) nanoparticles. Photodegradation experiments were performed to study the effect of various parameters including pH, catalyst dose, pollutant concentration and reaction time for three model compounds, methylene blue (MB), indigo carmine (IC), and ibuprofen (IBU) under visible light. Morphology and structure of the modified composite nanofibers were characterized by X-ray diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), Thermogravimetric analysis (TGA), Photoluminescence (PL) spectroscopy, Raman spectra, and X-ray Photoelectron Spectra (XPS) analyses. The photocatalytic performance was achieved in a rather short time visible light (<30 min) and under low power intensity (125 W) compared to earlier reports. Kinetics data fitted well using pseudo-first order model to describe the mechanism of photocatalytic degradation processes. The stability and flexibility of the fabricated composite nanofibers allow their application in a continuous flow system and their re-use after several cycles.

Removal of hexavalent chromium by electrospun PAN/GO decorated ZnO.

A novel composite nanofibers material have fabricated by using electrospinning technique followed by chemical cross-linking with zinc oxide (ZnO). The surface sensitization and morphology changes of the fabricated composite nanofibers were studied by using X-Ray Diffraction (XRD) analysis, Scanning Electron Microscopy (SEM) and transmission electron microscope (TEM). The effect of operating parameters includes the amount of ZnO, initial solution PH, and hexavalent chromium concentration on adsorption were investigated. The maximum adsorption capacity was found to be 690 mg/g at pH 6, which is much higher than most of the reported adsorbents. The adsorption equilibrium reached within 25 and 180 min as the initial solution concentration increased from 10 to 300 mg/L, and the data fitted well using nonlinear pseudo first order model with determination coefficient (R2) in between 0.97 and 0.99. Adsorption isotherms correlate the data on equilibrium adsorption with different mathematical models to describe the behaviour of an adsorption process and provide valuable information for optimizing the design of an adsorption system.

High performance of PAN/GO-ZnO composite nanofibers for photocatalytic degradation under visible irradiation.

In this work, Polyacrylonitrile nanofibers were enhanced by graphene oxide and zinc oxide, in terms of enhanced the photocatalytic activity and mechanical properties for the composite nanofibers. Photocatalytic degradation of two organic dyes methylene blue dye and indigo carmine dye from the simulated industrial wastewaters has been investigated under visible light irradiation. Composite nanofibers fabricated by using electrospinning technique followed by chemical cross-linking with zinc oxide. The surface sensitization and morphology changes of the fabricated composite nanofibers were studied using Fourier transform infrared spectroscopy analysis, Scanning Electron Microscopy and transmission electron microscope. Sensitized zinc oxide with graphene oxide showed higher efficiency in the degradation of MB with a 96% of degradation efficiency after 70 min and 98% for IC after merely 27 min. The optimum catalytic parameters such as initial organic dye concentration and pH were discussed. The efficacy of degradation of methylene blue dye and indigo carmine increased as initial concentration decreased. The optimal pH was around 5 where the reaction rate decreases above and under this pH value.

OXA-48-producing Enterobacteriaceae causing bacteremia, United Arab Emirates.

OXA-48-producing isolates were identified in approximately 4% and less than 1% of ESBL-producing and non-ESBL-producing E. coli and K. pneumoniae causing bacteremia at the largest tertiary hospital in Abu Dhabi.

The impact of acculturation on diabetes risk among Arab Americans in Southeastern Louisiana.

PURPOSE: This study was conducted to investigate the relationship between acculturation and diabetes risk among Arab Americans in Southeastern Louisiana. The secondary objective was to identify the prevalence of diabetes, hypertension, hyperlipidemia, and cardiovascular disease in the same population. BACKGROUND: Research suggests that Arab Americans report disproportionate rates of diabetes and other chronic diseases. METHODS: A cross-sectional study of 181 Arab Americans was conducted in Louisiana. Interviewers recruited participants to answer a 37-item survey with a five-dimension acculturation assessment and abridged National Institute of Health Survey and American Diabetes Association (2010) diabetes tool. Results were analyzed using factor analysis and Spearman's correlation. RESULTS: A negative correlation was found between Arab acculturation variables and diabetes risk among males (r=-.216, p=.044) and American acculturation variables among females (r=-.222, p=.032). Twelve percent reported being diagnosed with Type II diabetes by a primary care physician.

Effect of vaginal pH on the efficacy of vaginal misoprostol for induction of midtrimester abortion.

AIM: To evaluate the effect of vaginal pH on the efficacy of misoprostol for induction of midtrimester abortion. METHODS: The study comprised 110 women, with a gestational age of 14-26 weeks, with a missed abortion as an indication for the induction of abortion. On admission, the vaginal pH was measured and two groups were generated: (A) those with pH<5 (n=63); and (B) those with pH >or= 5 (n=47). All of the women received intravaginal misoprostol tablets moistened with 3 mL of 5% acetic acid, 200 microg every 4 h for a maximum of 5 doses within 24 h. If the patient did not have adequate uterine contractions, the same regimen was repeated over the following 24 h and if no response was achieved, this was considered a failure of therapy. RESULTS: All patients aborted within 48 h. A significant positive correlation between vaginal pH and the misoprostol application-abortion interval was found. The mean induction-abortion interval was significantly shorter in group A compared to group B (12.1 vs 23.6 h, P<0.001), with abortion rates at 24 h being 100% and 63.8%, respectively. Moreover, a significantly lower dose of misoprostol was used in group A with a lower incidence of fever and abdominal pain. CONCLUSION: Vaginal pH influences the efficacy of misoprostol administered vaginally for the induction of midtrimester abortion. The presence of this relationship, despite premoistening misoprostol with an acidifying agent, suggests that the effect of vaginal pH might extend beyond affecting the pharmacokinetics of the drug.