Covalent-Organic Framework-Based Materials in Theranostic Applications: Insights into Their Advantages and Challenges.

Nanomedicine has been essential in bioimaging and cancer therapy in recent years. Nanoscale covalent-organic frameworks (COFs) have been growing as an adequate classification of biomedical nanomaterials with practical application prospects because of their increased porosity, functionality, and biocompatibility. The high sponginess of COFs enables the incorporation of distinct imaging and therapeutic mechanisms with a better loading efficiency. Nevertheless, preliminary biocompatibility limits their possibility for clinical translation. Thus, cutting-edge nanomaterials with high biocompatibility and improved therapeutic efficiency are highly expected to fast-track the clinical translation of nanomedicines. The inherent effects of nanoscale COFs, such as proper size, modular pore geometry and porosity, and specific postsynthetic transformation through simple organic changes, make them particularly appealing for prospective nanomedicines. The organic building blocks of COFs may also be postmodified for particular binding to biomarkers. The exceptional features of COFs cause them to be an encouraging nanocarrier for bioimaging and therapeutic applications. In this review, we have systematically discussed the advances of COFs in the field of theranostics by providing essential features of COFs along with their synthetic methods. Further, the applications of COFs in the field of theranostics (such as drug delivery systems, photothermal, and photodynamic therapy) are discussed in detail with the help of available literature to date. Furthermore, the advantages of COFs over other materials for therapeutics and drug delivery are discussed. Finally, the review concludes with potential future COF applications in the theranostic field.

Evaluation of Acute Outcomes and Factors Influencing the Care of Chest Trauma in a District General Hospital in the United Kingdom.

Background The rate of chest trauma admissions under the Queen Hospital Burton Orthopedic team has been steadily increasing, surpassing other hospital trusts. Patients are managed locally by the Orthopedic department, unlike in major trauma centres. Understanding the management outcomes and patient factors in this setting is crucial for enhancing patient safety. Methodology A retrospective analysis of 139 patients with chest trauma referred to the QHB Orthopedic team from October 2017 to May 2021 was conducted using the Meditech-V6 electronic medical records system (Meditech, Westwood, US). This study aims to evaluate the outcomes of patients admitted with chest trauma and improve current practices. The objectives include assessing patient factors influencing outcomes, initiating discussions with a major trauma centre, and enhancing the quality of care for chest trauma patients. Results The mechanism of injury in all cases of chest injuries was blunt trauma, accounting for 100% of the cases. The specific mechanisms of injury observed in the study included falls from standing, falls from height, road traffic collisions, and assault. The study comprised 139 individuals, 128 of whom were diagnosed with rib fractures, and 11 who did not have any rib fractures. In addition, two patients were hospitalized with bilateral rib fractures, both of which were life-threatening. Tragically, one of these cases resulted in the death of the patient. With regard to outcomes, 67% of the patients received a consultation at Royal Stoke Hospital (RSH). Eight individuals were transferred to RSH for further management, while the remaining 131 patients were not transferred. Eighty-seven individuals were discharged from the hospital, indicating successful recovery and readiness for discharge. However, it is noteworthy that nine patients experienced complications during their hospital stay, highlighting the potential challenges and risks associated with chest trauma management. Tragically, seven patients succumbed to their injuries and passed away.  Conclusions The majority of patients in this study were aged 65 and over and presented with multiple comorbidities, indicating the complex medical profile of this population. However, despite the presence of life-threatening injuries and the associated risks, only a minority of patients in the study were transferred to a designated trauma centre. This raises concerns about the adequacy of the current transfer protocols and the potential impact on patient outcomes.

Repositioning the existing drugs for neuroinflammation: a fusion of computational approach and biological validation to counter the Parkinson's disease progression.

Parkinson's disease is caused by the deficiency of striatal dopamine and the accumulation of aggregated α-synuclein in the substantia nigra pars compacta (SNpc). Neuroinflammation associated with oxidative stress is a key factor contributing to the death of dopaminergic neurons in SNpc and advancement of Parkinson's disease. Two molecular targets, i.e., nuclear factor kappa-light-chain-enhancer (NF-kB) and α-synuclein play a substantial role in neuroinflammation progression. Therefore, the compounds targeting these neuroinflammatory targets hold a great potential to combat Parkinson's disease. Thereby, in this study, molecular docking and Connectivity Map (CMap) based gene expression profiling was utilized to reposition the approved drugs as neuroprotective agents for Parkinson's disease. With in silico screening, two drugs namely theophylline and propylthiouracil were selected for anti-neuroinflammatory activity evaluation in in vivo models of chronic neuroinflammation. The neuroinflammatory effect of the identified compounds was confirmed by quantifying the expression of three important neuroinflammatory mediators, i.e. IL-6, TNF-alpha, and IL-1 beta on brain tissue using ELISA assay. The ELISA experiment demonstrated that both compounds significantly decreased the expression of neuroinflammatory mediators, highlighting the compounds' potential in neuroinflammation management. Furthermore, the drug and disease interaction network of the two identified drugs and diseases (neuroinflammation and Parkinson's disease) suggested that the two drugs might interact with various targets namely adenosine receptors, Poly [ADP-ribose] polymerase-1, myeloperoxidase (MPO) and thyroid peroxidase through multiple pathways associated with neuroinflammation and Parkinson's disease. Computational studies suggest that a particular drug may be effective in managing Parkinson's disease associated with neuroinflammation. However, further research is needed to confirm this in biological experiments.

Single cell profiling at the maternal-fetal interface reveals a deficiency of PD-L1+ non-immune cells in human spontaneous preterm labor.

The mechanisms that underlie the timing of labor in humans are largely unknown. In most pregnancies, labor is initiated at term (≥ 37 weeks gestation), but in a signifiicant number of women spontaneous labor occurs preterm and is associated with increased perinatal mortality and morbidity. The objective of this study was to characterize the cells at the maternal-fetal interface (MFI) in term and preterm pregnancies in both the laboring and non-laboring state in Black women, who have among the highest preterm birth rates in the U.S. Using mass cytometry to obtain high-dimensional single-cell resolution, we identified 31 cell populations at the MFI, including 25 immune cell types and six non-immune cell types. Among the immune cells, maternal PD1+ CD8 T cell subsets were less abundant in term laboring compared to term non-laboring women. Among the non-immune cells, PD-L1+ maternal (stromal) and fetal (extravillous trophoblast) cells were less abundant in preterm laboring compared to term laboring women. Consistent with these observations, the expression of CD274, the gene encoding PD-L1, was significantly depressed and less responsive to fetal signaling molecules in cultured mesenchymal stromal cells from the decidua of preterm compared to term women. Overall, these results suggest that the PD1/PD-L1 pathway at the MFI may perturb the delicate balance between immune tolerance and rejection and contribute to the onset of spontaneous preterm labor.

Lenalidomide Augments Differentiation of Cultured Hair Follicle Derived Melanocyte Stem Cells Into Functional Melanocytes.

INTRODUCTION: Melanocyte progenitors are embryonically derived from the neural crest and subsequently get localized in hair follicles and epidermis to provide hair and skin pigmentation. These progenitor cells in hair follicles repeatedly proliferate and differentiate to maintain pigmentation. Vitiligo, a pigmentary disorder, is associated with loss of melanocytes. Repigmentation of vitiligo lesions mainly depends upon the proliferation, migration and differentiation of melanocyte stem cells (MelSCs) into functional melanocytes. The current study is designed to check the efficacy of lenalidomide, an imide drug in the differentiation of MelSCs into functional melanocytes. OBJECTIVES: The aim of the study is to check the effect of lenalidomide in the proliferation, migration of cultured hair follicle derived melanocyte stem cells and their differentiation into functional melanocytes. METHODS: Primary culture of MelSCs was established from whisker hair of C57BL/6 mice. Proliferation and migration of cultured cells were done by MTT assay and Boyden's chamber migration assay, respectively. Effect of lenalidomide on the MelSCs differentiation was checked at gene level by qPCR and protein expression was checked by immunocytochemistry. RESULTS: A significant increase in the migration of MelSCs in comparison to control was also observed. Lenalidomide treatment significantly increased the expression of melanocyte specific genes in cultured MelSCs as compared to control. CONCLUSIONS: From the results we concluded that lenalidomide induce the proliferation and migration of MelSCs and accelerate the differentiation of MelSCs into functional melanocytes.

Significance of an Electrochemical Sensor and Nanocomposites: Toward the Electrocatalytic Detection of Neurotransmitters and Their Importance within the Physiological System.

A prominent neurotransmitter (NT), dopamine (DA), is a chemical messenger that transmits signals between one neuron to the next to pass on a signal to and from the central nervous system (CNS). The imbalanced concentration of DA may cause numerous neurological sicknesses and syndromes, for example, Parkinson's disease (PD) and schizophrenia. There are many types of NTs in the brain, including epinephrine, norepinephrine (NE), serotonin, and glutamate. Electrochemical sensors have offered a creative direction to biomedical analysis and testing. Researches are in progress to improve the performance of sensors and develop new protocols for sensor design. This review article focuses on the area of sensor growth to discover the applicability of polymers and metallic particles and composite materials as tools in electrochemical sensor surface incorporation. Electrochemical sensors have attracted the attention of researchers as they possess high sensitivity, quick reaction rate, good controllability, and instantaneous detection. Efficient complex materials provide considerable benefits for biological detection as they have exclusive chemical and physical properties. Due to distinctive electrocatalytic characteristics, metallic nanoparticles add fascinating traits to materials that depend on the material's morphology and size. Herein, we have collected much information on NTs and their importance within the physiological system. Furthermore, the electrochemical sensors and corresponding techniques (such as voltammetric, amperometry, impedance, and chronoamperometry) and the different types of electrodes' roles in the analysis of NTs are discussed. Furthermore, other methods for detecting NTs include optical and microdialysis methods. Finally, we show the advantages and disadvantages of different techniques and conclude remarks with future perspectives.

Protocol optimization and assessment of genotypic response for inbred line development through doubled haploid production in maize.

BACKGROUND: Doubled haploid technology offers the fastest route of inbred line development by rapidly fixing the desirable combinations in a single year. However, the differential response of haploid induction to genetic background of maternal lines accompanied with low induction rate and high mortality rate due to artificial chromosomal doubling of haploid seedlings creates hindrance in doubled haploid production on a commercial scale under tropical conditions. To speed up the hybrid breeding programme in sub-tropical maize, efforts are reported here to optimize the protocol for efficient production of fixed lines using haploid inducers. The second-generation haploid inducers i.e. CIM2GTAILs obtained from CIMMYT, Mexico were used for haploid induction in 13 F1s of diverse backgrounds. For standardization of chromosomal doubling protocol, various concentrations of colchicine and two seedling growth stages were used to determine the extent of chromosomal doubling and survival rate of doubled haploid plants. RESULTS: A high mean haploid induction rate is obtained from CIM2GTAIL P2 (10%) as compared to CIM2GTAIL P1 (7.46%). Out of four treatments, CIMMYT reported protocol of chromosome doubling in tropical maize comprising combination of 0.07% colchicine and 0.1% DMSO at V2 stage is highly effective for acquiring doubled haploid plants in sub-tropical adapted maize with high survival rate of 52.7%. However, increasing the colchicine concentration from 0.07 to 0.1% led to high mortality rate. CONCLUSION: According to the findings, the haploid induction rate, survival rate and overall success rate varied depending upon the genotype of the inducer and the source population along with the concentrations of chemical used. The optimized protocol developed using CIMMYT haploid inducer CIM2GTAIL P2 for efficient doubled haploid production will not only fasten the breeding programme but will also reduce the production cost of doubled haploid with great efficiency in sub-tropical maize.

DNA-free genome editing for ZmPLA1 gene via targeting immature embryos in tropical maize.

Doubled haploid (DH) production accelerates the development of homozygous lines in a single generation. In maize, haploids are widely produced by the use of haploid inducer Stock 6, earlier reported in 1959. Three independent studies reported haploid induction in maize which is triggered due to a 4 bp frame-shift mutation in matrilineal (ZmPLA1) gene. The present study was focused on the generation of mutants for ZmPLA1 gene in maize inbred line LM13 through site-directed mutagenesis via CRISPR/Cas9-mediated ribonucleoprotein (RNP) complex method to increase the haploid induction rate. Three single guide RNAs (sgRNAs) for the ZmPLA1 gene locus were used for transforming the 14 days old immature embryos via bombardment. 373 regenerated plants were subjected to mutation detection followed by Sanger's sequencing. Out of three putative mutants identified, one mutant depicted one base pair substitution and one base pair deletion at the target site.

Metal-Organic Framework-Based Materials for Wastewater Treatment: Superior Adsorbent Materials for the Removal of Hazardous Pollutants.

In previous years, different pollutants, for example, organic dyes, antibiotics, heavy metals, pharmaceuticals, and agricultural pollutants, have been of note to the water enterprise due to their insufficient reduction during standard water and wastewater processing methods. MOFs have been found to have potential toward wastewater management. This Review focused on the synthesis process (such as traditional, electrochemical, microwave, sonochemical, mechanochemical, and continuous-flow spray-drying method) of MOF materials. Moreover, the properties of the MOF materials have been discussed in detail. Further, MOF materials' applications for wastewater treatment (such as the removal of antibiotics, organic dyes, heavy metal ions, and agricultural waste) have been discussed. Additionally, we have compared the performances of some typical MOFs-based materials with those of other commonly used materials. Finally, the study's current challenges, future prospects, and outlook have been highlighted.

Neuromodulatory effect of 4-(methylthio)butyl isothiocyanate against 3-nitropropionic acid induced oxidative impairments in human dopaminergic SH-SY5Y cells via BDNF/CREB/TrkB pathway.

Mitochondrial impairment, energetic crisis and elevated oxidative stress have been demonstrated to play a pivotal role in the pathological processes of Huntington's disease (HD). 3-Nitropropionic acid (3-NPA) is a natural neurotoxin that mimics the neurological dysfunctions, mitochondrial impairments and oxidative imbalance of HD. The current investigation was undertaken to demonstrate the neuroprotective effect of 4-(methylthio)butyl isothiocyanate (4-MTBITC) against the 3-NPA induced neurotoxicity in human dopaminergic SH-SY5Y cells. The experimental evidence of oxidative DNA damage by 3-NPA was elucidated by pBR322 DNA nicking assay. In contrast, the 4-MTBITC considerably attenuated the DNA damage, suggesting its free radical scavenging action against 3-NPA and Fenton's reagent. The dose and time-dependent increase of 3-NPA revealed its neurotoxic dose as 0.5 mM after 24 h of treatment of SH-SY5Y cells in MTT assay. In order to determine the optimal dose at which 4-MTBITC protects cell death, the 3-NPA (IC50) induced cells were pretreated with different concentrations of 4-MTBITC for 1 h. The neuroprotective dose of 4-MTBITC against 3-NPA was found to be 0.25 µM. Additionally, the elevated GSH levels in cells treated with 4-MTBITC indicate its propensity to eliminate reactive species generated as a result of 3-NPA-induced mitochondrial dysfunction. Likewise, it was determined through microscopic and flow cytometric experiments that 3-NPA's induced overproduction of reactive species and a decline in mitochondrial membrane potential (MMP) could be efficiently prevented by pre-treating cells with 4-MTBITC. To elucidate the underlying molecular mechanism, the RT-qPCR analysis revealed that the pre-treatment of 4-MTBITC effectively protected neuronal cells against 3-NPA-induced cell death by preventing Caspase-3 activation, Brain-derived neurotrophic factor (BDNF) upregulation, activation of cAMP response element-binding protein (CREB) and Nrf2 induction. Together, our findings lend credence to the idea that pre-treatment with 4-MTBITC reduced 3-NPA-induced neurotoxicity by lowering redox impairment, apoptotic state, and mitochondrial dysfunction. The present work, in conclusion, presented the first proof that the phytoconstituent 4-MTBITC supports the antioxidant system, BDNF/TrkB/CREB signaling, and neuronal survival in dopaminergic SH-SY5Y cells against 3-NPA-induced oxidative deficits.

Results of Wedgeless Distal Femoral Osteotomy for the Treatment of Genu Valgus Deformity.

INTRODUCTION: Coronal plane knee deformities are common disorders affecting adolescents. Valgus deformities (tibiofemoral angle (TFA) > 12-15 degrees and intermalleolar distance (IMD) > 10 cm) often require corrective osteotomy and a wedgeless "V" distal femoral osteotomy is a good treatment option for such deformities. MATERIALS AND METHODS: Thirty adolescent patients (13-17 years) with valgus deformities were included. Patients with severe collateral ligament instability, subluxation, and sagittal plane deformity > 15 degrees or genu valgum due to tibial deformity were excluded. Preoperative clinical (Bostman's knee score, IMD, and knee-flexion test) and radiological evaluations were done. The surgery (wedgeless distal femoral V osteotomy) was performed and stabilized with two Kirschner wires (K-wires). Postoperative clinical and radiological parameters were recorded including complications. RESULTS: The preoperative TFA was 20.23 ± 3.63 degrees, which reduced to 5.5 ± 0.73 at six months postoperatively. The preoperative IMD was 12.45 ± 2.2 cm, which reduced to 1.63 ± 0.32 cm at six months. The mean mechanical axis deviation (MAD) and lateral distal femoral angle (LDFA) were recorded as 2.8 ± 0.39 and 87.7 ± 0.83, respectively, and the differences were statistically significant from preoperative values. The Bostman score was 26.2 ± 1.79 at three months and 29.47 ± 0.9 at six months. The complications included infection in two patients, a hypertrophic scar in one patient, and common peroneal neuropraxia in one patient. CONCLUSION: Wedgeless distal femoral osteotomy with K-wire fixation is a viable option for correction of genu valgus deformity with potential advantages of minimal blood loss, no leg length discrepancy, non-rigid fixation, and early union as compared to other treatment options.

Systematic Review of Current Approaches to Tibia Plateau: Best Clinical Evidence.

If not treated adequately, tibia plateau fractures result in premature osteoarthritis and lifelong disability. The advent of newer implants and techniques to improve outcomes has necessitated the development of different surgical approaches. A Medline and EMBASE search (June 2020) was conducted to identify publications during the last 10 years that focused on surgical approaches for proximal tibia fractures/ tibia plateau management. A total of 2107123 and 2715399 articles were found related to fractures in this area with 133 and 103 review articles looking at the approach on MEDLINE and EMBASE, respectively. This article reviews the continued development of the surgical approaches to aid understanding for surgeons and identify areas for future research to help improve outcomes. Although the anterolateral approach is the most commonly applied surgical technique, having the knowledge of newer approaches (medial, posteromedial, posterolateral, or direct posterior) in the armamentarium is necessary to treat the vast array of fracture patterns. There has been a shift amongst trauma surgeons of using a combination of approaches for complex tibia plateau fractures.

Identifying Gingival Pigmentation Patterns and Skin Color and Its Co-relation With Serum Ferritin Levels in Thalassemic Patients.

BACKGROUND: Patients with ß-thalassemia major (ß-TM), a genetic issue due to hemoglobin (Hb) synthesis disorder, require life-long erythrocyte transfusion. The purpose of this study is to evaluate and compare gingival pigmentation and skin color with serum ferritin levels of patients with ß-TM, using the Dummett's oral pigmentation index (DOPI) and Fitzpatrick skin scale, respectively. METHODS: A total of 100 patients were monitored at a thalassemia care center. Each patient's gingival pigmentation and skin color were matched with DOPI and the skin scale under natural light. Serum ferritin levels, the interval of blood transfusions, and iron chelation medications were studied. A gingival pigmentation score and skin color type were compared with the serum ferritin. RESULTS: A significant correlation was found between age, serum ferritin, pigmentation score, and skin color, which means as serum ferritin level increases, gingival pigmentation score increases, and skin color darkens. CONCLUSION: This study evaluated the correlation between gingival pigmentation and skin color with serum ferritin levels and established gingival pigmentation as a sign of iron deposition in ß-TM patients. This is the simplest and least invasive method for evaluating serum ferritin level parameters in ß-TM patients.

Recent advances in electrochemical-based sensors amplified with carbon-based nanomaterials (CNMs) for sensing pharmaceutical and food pollutants.

Foodborne-related infections due to additives and pollutants pose a considerable task for food processing enterprises. Therefore, the competent, cost-effective, and quick investigation of nutrition additives and contaminants is essential to reduce the threat of public fitness problems. The electrochemical sensor (ECS) shows facile and potent analytical approaches desirable for food protection and quality inspection over traditional methods. The consequence of a broad display of nanomaterials has paved the path for their relevance in designing high-performance ECSs appliances for medical diagnostics and conditions and food protection. This review article has discussed the importance of electrochemical-based sensors amplified with carbon-based nanomaterials (CNMs). Initially, we have demonstrated the types of pharmaceutical and food/agriculture pollutants (such as pesticides, heavy metals, antibiotics and other medical drugs) present in water. Subsequently, we have compiled the information on electrochemical techniques (such as voltammetric and electrochemical impedance spectroscopy) and their crucial parameters for detecting pollutants. Further, the applications of CNMs for sensing pharmaceutical and food pollutants have been demonstrated in detail. Finally, the topic has been concluded with existing challenges and future prospects.

Recent advances of carbon-based nanomaterials (CBNMs) for wastewater treatment: Synthesis and application.

Carbon-based nanomaterials (CBNMs) have attracted significant alert due to the affluent science underpinning their implementations associated with a novel mixture of high aspect proportions, greater thermal and electrical performance, outstanding optical features, and high exterior area. CBNMs not only bear assurance in a broad range of implementations in medication, nano and microelectronics, and ecological remedies but may also be utilized in practical laboratory determinations. More specifically, CBNMs perform as an outstanding adsorbent in terminating heavy metal ions (HMI) from wastewater. There is presently a deficiency of powerful threat inspection instruments owing to their complex detection and related deficit in the health risk database. Therefore, our present review concentrates on spreading CBNMs to release pollutants from wastewater. The article wraps the effect of these contaminants and photocatalytic strategies towards treating these mixtures in wastewater, along with their restrictions and challenges, convincing resolutions, and possibilities of these approaches.

Role of Silver Nanoparticle-Doped 2-Aminodiphenylamine Polymeric Material in the Detection of Dopamine (DA) with Uric Acid Interference.

A viable electrochemical approach for the detection of dopamine (DA) in uric acid (UA) utilizing a silver nanoparticle-doped 2-aminodiphenylamine (AgNPs-2ADPA) electrode was invented. The electrochemical performance of DA showed that the incorporated electrode displayed outstanding electrocatalytic performance to the electrochemical oxidation of DA. In our study, the AgNPs-2ADPA exhibits remarkable catalytic activity, retaining high current value and resilience when employed as a working electrode component for electrocatalytic detection of DA. We have also utilized the bare and polymeric-2ADPA in DA detection for a comparison study. This method offers a facile route with extraordinary sensitivity, selectivity, and strength for the voltammetric detection of DA, even in the presence of UA and ascorbic acid (AA) as interferents, that can be employed for pharmaceutical and biological specimens.

Novel synthesis methods and applications of MXene-based nanomaterials (MBNs) for hazardous pollutants degradation: Future perspectives.

MXenes are a quickly growing and extended group of two-dimensional (2D) substances that have earned unbelievable analysis credits for various application areas within different manufacturing areas. Due to novel essential architectural and physicochemical properties shows good properties, such as elevated exterior area, living adaptability, strong electrochemistry, and great hydrophilicity. Given the fast progress within the structure and synthesis of MBNs for water treatment, quick updates on this research field are required to remove toxic substances, such as production approaches and characterization methods for the advantages and constraints of MXenes for pollutant degradation. MXenes are determined as a proposed road toward atmosphere-clean-up machinery to identify and decrease a pattern of hazardous resistant pollutants from environmental forms. Here, in this review article, we have been focused on describing the overview, novel synthesis methods, and characteristics of the MXene-based nanomaterials (MBNs) in the field for removing hazardous contaminants from environmental conditions. In the last, the utilizations of MBNs in water sanitization, organic solvent filtration, antibiotics degradation, pesticide degradation, heavy metals degradation, ions removal, bacterial pathogens degradation, along with the conclusion, challenges, and prospects in this field, have been discussed.

Postpartum Outcomes With Systematic Treatment and Management of Postpartum Hypertension.

OBJECTIVE: To test the ability of a hospital-wide, bundled quality-improvement initiative to improve postpartum maternal blood pressure control and adherence to postpartum follow-up among patients with hypertensive disorders of pregnancy. METHODS: This quality-improvement initiative consisted of a bundle of clinical interventions including health care professional and patient education, a dedicated nurse educator, and protocols for postpartum hypertensive disorders of pregnancy care in the inpatient, outpatient and readmission setting. We implemented this initiative in patients with hypertensive disorders of pregnancy starting in January 2019 at the University of Chicago. The study period was divided into four periods, which correspond to preintervention, distinct bundle roll outs, and postintervention. Our primary outcome was postpartum hypertension visit adherence. Secondary outcomes included blood pressure values and antihypertensive medication use in the immediate postpartum and outpatient postpartum time periods. We then stratified our outcomes by race to assess whether the effect size differed. RESULTS: A total of 926 patients who delivered between September 2018 and November 2019 were included. Postpartum hypertension visit adherence improved from preintervention period compared with the full implementation period (33.5% vs 59.4%, P<.001). Blood pressure in the first 24 hours postpartum decreased from preintervention compared with full implementation (preintervention median [interquartile range] systolic blood pressure 149 mm Hg [138, 159] vs 137 [131, 146] in postimplementation; P<.001). After implementation, fewer patients experienced a blood pressure of 140/90 mm Hg or higher at the first postpartum blood pressure check, when compared with preintervention (39.1% vs 18.5%, P=.004). The effect size did not differ by race. CONCLUSION: A bundled quality-improvement initiative for patients with hypertensive disorders of pregnancy was associated with improved postpartum visit adherence and blood pressure control in the postpartum period.

Key ingredients and recycling strategy of personal protective equipment (PPE): Towards sustainable solution for the COVID-19 like pandemics.

The COVID-19 pandemic has intensified the complications of plastic trash management and disposal. The current situation of living in fear of transmission of the COVID-19 virus has further transformed our behavioural models, such as regularly using personal protective equipment (PPE) kits and single-use applications for day to day needs etc. It has been estimated that with the passage of the coronavirus epidemic every month, there is expected use of 200 billion pieces of single-use facemasks and gloves. PPE are well established now as life-saving items for medicinal specialists to stay safe through the COVID-19 pandemic. Different processes such as glycolysis, hydrogenation, aminolysis, hydrolysis, pyrolysis, and gasification are now working on finding advanced technologies to transfer waste PPE into value-added products. Here, in this article, we have discussed the recycling strategies of PPE, important components (such as medical gloves, gowns, masks & respirators and other face and eye protection) and the raw materials used in PPE kits. Further, the value addition methods to recycling the PPE kits, chemical & apparatus used in recycling and recycling components into value-added products. Finally, the biorenewable materials in PPE for textiles components have been discussed along with concluded remarks.

Assessment of barriers and motivators to online learning among medical undergraduates of Punjab.

BACKGROUND: The current corona virus disease 2019 (COVID-19) pandemic has led to the disruption of academic activities including medical education which has made online learning only available options for continuing education worldwide. Online learning has its own limitations, which are further amplified if not implemented properly. Hence, there is a need to assess various barriers faced in the implementation of effective online learning. OBJECTIVES: The objective of the study was to identify the barriers and motivators in online learning among medical undergraduates. SUBJECTS AND METHODS: This internet-based cross-sectional study was conducted among medical undergraduates of Punjab. The data collection tool was a semi-structured self-made questionnaire prepared using "Google Forms," which was then circulated in the WhatsApp groups of the students. Received responses were imported to the Microsoft Excel sheet and statistical analysis was done. RESULTS: Out of the 592 participants, 533 (90%) faced some kind of problem in online learning. Major among them were lack of personal interaction with teachers (52%), distractions at home (43.6%), technology failure (43.2%), limited access to the Internet (39.2%), visual fatigue (38.5%), and increased workload (25%). Benefits perceived were the comfortable environment of home (41%), easy accessibility of recorded lectures (36.8%), and the opportunity to keep in touch with studies (35%). CONCLUSIONS: The online learning process is not a replacement for routine classroom teaching and clinical postings in medical education. However, it can supplement routine teaching, especially during current COVID-19 pandemic-like situations. Most of the students (90%) were facing some kind of difficulty in the online learning process due to unplanned and sudden shifts. Therefore, it is necessary to identify and eliminate the various barriers to make online learning effective.