Perception of residents on the impacts of beach tourism: The case of Nungwi village in Zanzibar, Tanzania.

This study aimed to assess the perception of residents on the impacts of beach tourism in Nungwi village, one of the most lively beach tourist spots in Zanzibar, Tanzania. Data collection was carried out between June and August 2021 from 174 residents using a structured questionnaire. Descriptive statistics, T-tests and One-way ANOVA were employed. The revealed positively perceived impacts include the increase in entrepreneurial opportunities, employment, and access to basic social services. The study also identified the increase in income inequalities as well as cost of living to be the key aspects perceived negatively by the residents. The findings suggest occupation is a key differentiating factor in the association of tourism development to residents' pride in local culture, with corporate employees and entrepreneurs more likely to view positive contribution of tourism to residents' pride in local culture than farmers and fishermen. Furthermore, the study confirmed the heterogeneity of residents' perceptions regarding tourism impacts which were caused by five key variables, namely: length of residence in the area, occupation type, sex, age, and level of income. The study findings help to increase the baseline knowledge available to tourism stakeholders and insights that may be considered when developing and implementing tourism-related policies and plans. The study contributes to the residents' perception literature in a rural developing country context.

Exploring gold mineralization in altered ultramafic rocks in south Abu Marawat, Eastern Desert, Egypt.

Gold mining is an important strategic sector. The search for mineral reserves is moving deeper as more accessible shallow resources are discovered. Geophysical techniques are now being employed more frequently in mineral exploration because they are quick and can provide crucial subsurface information for discovering potential metal deposits, particularly in high-relief and inaccessible places. The potential for gold in a large-scale gold mining (LSGM) locality in the South Abu Marawat area is investigated using a geological field investigation that includes rock sampling, structural measurements, detailed petrography, reconnaissance geochemistry, and thin section analysis, integrated with various transformation filters of surface magnetic data (analytic signal, normalized source strength, tilt angle), contact occurrence density maps, and tomographic modelling for the subsurface magnetic susceptibilities. The benefits of remote sensing (RS) and its technology in mapping detailed rock differentiation, and characterizing physical objects on the land surface using various spatial, and spectral resolution datasets are integrated. Both aeromagnetic and measured land magnetic profiles are used to investigate the area's present geological conditions and possible future mining localities. Results indicate that gold mineralization in the study area is linked to the altered ultramafic zones that are associated with faulting and shearing and characterized by a low magnetic susceptibility anomaly.

Design, synthesis and antitumor activity of novel pyran-functionalized uracil derivatives: docking studies.

Aim: Synthesis of novel pyran-based uracils that may have potent antitumor activity against hepatocellular carcinoma HepG2 and ovarian cancer SKOV3 cell lines. Materials & methods: Novel pyran-based uracils were synthesized and their anticancer activity was assessed using methyl thiazolyl tetrazolium and wound-healing assays to detect their cytotoxicity and their antiproliferative and antimigratory activities. Results: Compounds 3, 5, 6, 7, 8, 9, 10, 11 and 13 significantly inhibited cell proliferation of the HepG2 cell line. Compounds 7, 8, 9 and 13 significantly inhibited the proliferation of SKOV3 cells, which was also proven through docking studies with topoisomerase I. Conclusion: The molecular docking analysis revealed that 7 and 9 are two major compounds found to possess higher degrees of interaction with DNA gyrase.

Matched Ligands for Small, Stable Colloidal Nanoparticles of Copper, Cuprous Oxide and Cuprous Sulfide.

This work applies organometallic routes to copper(0/I) nanoparticles and describes how to match ligand chemistries with different material compositions. The syntheses involve reacting an organo-copper precursor, mesitylcopper(I) [CuMes]z (z=4, 5), at low temperatures and in organic solvents, with hydrogen, air or hydrogen sulfide to deliver Cu, Cu2 O or Cu2 S nanoparticles. Use of sub-stoichiometric quantities of protonated ligand (pro-ligand; 0.1-0.2 equivalents vs. [CuMes]z ) allows saturation of surface coordination sites but avoids excess pro-ligand contaminating the nanoparticle solutions. The pro-ligands are nonanoic acid (HO2 CR1 ), 2-[2-(2-methoxyethoxy)ethoxy]acetic acid (HO2 CR2 ) or di(thio)nonanoic acid, (HS2 CR1 ), and are matched to the metallic, oxide or sulfide nanoparticles. Ligand exchange reactions reveal that copper(0) nanoparticles may be coordinated by carboxylate or di(thio)carboxylate ligands, but Cu2 O is preferentially coordinated by carboxylate ligands and Cu2 S by di(thio)carboxylate ligands. This work highlights the opportunities for organometallic routes to well-defined nanoparticles and the need for appropriate ligand selection.

Dosimetric Study of Heat-Treated Calcium-Aluminum-Silicon Borate Dosimeter for Diagnostic Radiology Applications.

The production of thermoluminescence (TL) dosimeters fabricated from B2O3-CaF2-Al2O3-SiO2 doped with Cu and Pr for use in diagnostic radiology is the main goal of this research. The TL samples were synthesized via the melt-quench technique processed by melting the mixture at 1200 °C for 1 h, and, after cooling, the sample thus created was divided into two samples and retreated by heating for 2 h (referred to as TLV30) and for 15 h (referred to as TLV17). SEM and EDS analyses were performed on the TL samples to confirm the preparation process and to investigate the effects of irradiation dosimetry on the TL samples. Furthermore, the TL samples were irradiated with γ-rays using a 450 Ci 137Cs irradiator and variable X-ray beams (5-70 mGy). Two important diagnostic radiology applications were considered: CT (6-24 mGy) and mammography (2.72-10.8 mGy). Important dosimetric properties, such as the glow curves, reproducibility, dose-response linearity, energy dependence, minimum dose detectability and fading, were investigated for the synthetized samples (TLV17 and TLV30), the results of which were compared with the Harshaw TLD-100. The TLV17 dosimeter showed higher sensitivity than TLV30 in all applied irradiation procedures. The dose-response linearity coefficients of determination R2 for TLV17 were higher than TLD-100 and TLV30 in some applications and were almost equal in others. The reproducibility results of TLV17, TLV30 and TLD-100 were less than 5%, which is acceptable. On the other hand, the results of the fading investigations showed that, in general, TLV17 showed less fading than TLV30. Both samples showed a significant decrease in this regard after the first day, and then the signal variation became essentially stable though with a slight decrease until the eighth day. Therefore, it is recommended to read the TL dosimeters after 24 h, as with TLD-100. The SEM images confirmed the existence of crystallization, whilst the EDS spectra confirmed the presence of the elements used for preparation. Furthermore, we noticed that TLV17 had grown dense crystals that were larger in size compared to those of TLV30, which explains the higher sensitivity in TLV17. Overall, despite the fading, TLV17 showed greater radiation sensitivity and dose-response linearity compared with TLD-100. The synthetized TL samples showed their suitability for use as dosimeters in diagnostic radiology radiation dosimetry.

A Review of Incident Prediction, Resource Allocation, and Dispatch Models for Emergency Management.

In the last fifty years, researchers have developed statistical, data-driven, analytical, and algorithmic approaches for designing and improving emergency response management (ERM) systems. The problem has been noted as inherently difficult and constitutes spatio-temporal decision making under uncertainty, which has been addressed in the literature with varying assumptions and approaches. This survey provides a detailed review of these approaches, focusing on the key challenges and issues regarding four sub-processes: (a) incident prediction, (b) incident detection, (c) resource allocation, and (c) computer-aided dispatch for emergency response. We highlight the strengths and weaknesses of prior work in this domain and explore the similarities and differences between different modeling paradigms. We conclude by illustrating open challenges and opportunities for future research in this complex domain.

Intussusception among infants in Tanzania: findings from prospective hospital-based surveillance, 2013-2016.

INTRODUCTION: intussusception surveillance was initiated in Tanzania in 2013 after monovalent rotavirus vaccine was introduced, as part of the 7-country African evaluation to assess whether the vaccine was associated with an increased risk of intussusception. An increased risk from vaccine was not identified. Published data on intussusception in Tanzanian infants are limited. METHODS: prospective intussusception surveillance was conducted at 7 referral hospitals during 2013-2016 to identify all infants with intussusception meeting Brighton Level 1 criteria. Demographic, household and clinical data were collected by hospital clinicians and analyzed. RESULTS: a total of 207 intussusception cases were identified. The median age of cases was 5.8 months and nearly three-quarters were aged 4-7 months. Median number of days from symptom onset to admission at treatment hospital was 3 (IQR 2-5). Seventy-eight percent (152/195) of cases had been admitted at another hospital before transfer to the treating hospital. Enema reduction was not available; all infants were treated surgically and 55% (114/207) had intestinal resection. The overall case-fatality rate was 30% (62/206). Compared with infants who survived, those who died had longer duration of symptoms before admission to treatment hospital (median 4 vs 3 days; p < 0.01), higher rate of intestinal resection (81% [60/82] vs 44% [64/144], p < 0.001), and from families with lower incomes (i.e., less likely to own a television [p < 0.01] and refrigerator [p < 0.05). CONCLUSION: Tanzanian infants who develop intussusception have a high case-fatality rate. Raising the index of suspicion among healthcare providers, allocating resources to allow wider availability of abdominal ultrasound for earlier diagnosis, and training teams in ultrasound-guided enema reduction techniques used in other African countries could reduce the fatality rate.

Outcome and death risk of diabetes patients with Covid-19 receiving pre-hospital and in-hospital metformin therapies.

BACKGROUND: COVID-19 has stroke Brazil harshly, deaths by COVID-19 in Brazil represent almost 13% of the total deaths by COVID-19 in the world, even though Brazilian population represents only 2.6% of the world population. Our aim in this study was to evaluate death and intubation outcomes and risk factors associated with COVID-19, and treatment options focusing on diabetes patients and the use of metformin pre-admission and during hospitalization. METHODS: In this Brazilian single-center study we evaluated 1170 patients hospitalized due to COVID-19. Diabetes patients (n = 188) were divided based on their use of pre-hospital and in-hospital metformin (non-met-group and met-group). RESULTS: In the total cohort most comorbidities were risk factors for orotracheal intubation and death. The use of chloroquine/hydroxychloroquine was significantly associated with increased death and intubation risk in uni- and multivariate analysis. Diabetes patients showed worst clinical feature compared with non-diabetes patients. In-hospital non-met-group had increased mortality (20.5%) compared to met-group (3.5%) (p = 0.0002) and univariable cox proportion hazard regression indicated in-hospital metformin reduced mortality (HR = 0.325, p = 0.035). Patients that used pre-hospital metformin showed lower severity parameters at hospital admission. (met-group: 2.45 ± 2.5; non-met-group: 4.25 ± 3.4). In all the groups older patients showed more severe clinical conditions and high risk of death and intubation. CONCLUSION: Even though this is a single-center study, results from other reports have shown a similar trend, indicating that patients that used metformin during hospitalization have a better prognosis and reduced risk of death.

Wide-Bite-Angle Diphosphine Ligands in Thermally Activated Delayed Fluorescent Copper(I) Complexes: Impact on the Performance of Electroluminescence Applications.

We report a series of seven cationic heteroleptic copper(I) complexes of the form [Cu(P^P)(dmphen)]BF4, where dmphen is 2,9-dimethyl-1,10-phenanthroline and P^P is a diphosphine chelate, in which the effect of the bite angle of the diphosphine ligand on the photophysical properties of the complexes was studied. Several of the complexes exhibit moderately high photoluminescence quantum yields in the solid state, with ΦPL of up to 35%, and in solution, with ΦPL of up to 98%. We were able to correlate the powder photoluminescence quantum yields with the % Vbur of the P^P ligand. The most emissive complexes were used to fabricate both organic light-emitting diodes and light-emitting electrochemical cells (LECs), both of which showed moderate performance. Compared to the benchmark copper(I)-based LECs, [Cu(dnbp)(DPEPhos)]+ (maximum external quantum efficiency, EQEmax = 16%), complex 3 (EQEmax = 1.85%) showed a much longer device lifetime (t1/2 = 1.25 h and >16.5 h for [Cu(dnbp)(DPEPhos)]+ and complex 3, respectively). The electrochemiluminescence (ECL) properties of several complexes were also studied, which, to the best of our knowledge, constitutes the first ECL study for heteroleptic copper(I) complexes. Notably, complexes exhibiting more reversible electrochemistry were associated with higher annihilation ECL as well as better performance in a LEC.

Change management in medical institutions: implementation view

Change is a learning process modeling the attitudes and values of the involved staff to adapt and show the change in daily work life. Leading the change in medical schools or in the health care system is considered one of the assignments of successful leadership that can achieve an effective organizational change under complex conditions. This review aims to show an implementation view about how to manage the change in medical institutions and how to overcome obstacles, and how to face the challenges. The resistance to change represents a major obstacle to the change process in any medical school or health care system. Thus, it should address this resistance by creating a suitable climate for carrying out the change based on a flexible strategy that may be translated into practical steps during the implementation. Moreover, the change should be institutionalized wherein new behaviors are persisting and generalizing in the medical school or the health care system as a result of the change application. In addition, the successful management of change in any medical school or system requires a well-functioning and efficient management system for achieving the intended results. Therefore, many benefits may be gained as a result of the success of a change process in any organization wherein it improves the effectiveness and efficiency of organizational and staff performance besides creating an opportunity for getting the best practices (AU)

How to design and apply an Objective Structured Clinical Examination (OSCE) in medical education?

The Objective Structured Clinical Examination (OSCE) is considered a gold standard summative and formative assessment method wherein it is a comprehensive and standardized tool assessing the clinical competencies including psychomotor domain, attitudes, and behaviors that will be manifested in the real work of the medical graduates. Therefore, the implementation of OSCE depends on the design of a blueprint that consists of two axes; the first axis is the tested competencies according to the learning objectives while the second axis represents a system or problem that is related to these competencies. Thus, the blueprint of OSCE is a translation for the learning objectives into clinical competences such as history taking, physical examination, radiographic and laboratory data interpretation, technical skills, attitudinal behaviors, and counseling skills. In addition, the utility index proved that OSCE has a good balance for acceptability, reliability, validity, credibility, feasibility, cost, and educational impact. However, the use of OSCE for the students' assessment is considered expensive and exhausted because it requires many facilities, a great deal of the personnel besides the needed consuming time for its application (AU)

Quality of intrapartum care: direct observations in a low-resource tertiary hospital.

BACKGROUND: The majority of the world's perinatal deaths occur in low- and middle-income countries. A substantial proportion occurs intrapartum and is avoidable with better care. At a low-resource tertiary hospital, this study assessed the quality of intrapartum care and adherence to locally-tailored clinical guidelines. METHODS: A non-participatory, structured, direct observation study was held at Mnazi Mmoja Hospital, Zanzibar, Tanzania, between October and November 2016. Women in active labour were followed and structure, processes of labour care and outcomes of care systematically recorded. Descriptive analyses were performed on the labour observations and compared to local guidelines and supplemented by qualitative findings. A Poisson regression analysis assessed factors affecting foetal heart rate monitoring (FHRM) guidelines adherence. RESULTS: 161 labouring women were observed. The nurse/midwife-to-labouring-women ratio of 1:4, resulted in doctors providing a significant part of intrapartum monitoring. Care during labour and two-thirds of deliveries was provided in a one-room labour ward with shared beds. Screening for privacy and communication of examination findings were done in 50 and 34%, respectively. For the majority, there was delayed recognition of labour progress and insufficient support in second stage of labour. While FHRM was generally performed suboptimally with a median interval of 105 (interquartile range 57-160) minutes, occurrence of an intrapartum risk event (non-reassuring FHR, oxytocin use or poor progress) increased assessment frequency significantly (rate ratio 1.32 (CI 1.09-1.58)). CONCLUSIONS: Neither international nor locally-adapted standards of intrapartum routine care were optimally achieved. This was most likely due to a grossly inadequate capacity of birth attendants; without whom innovative interventions at birth are unlikely to succeed. This calls for international and local stakeholders to address the root causes of unsafe intrafacility care in low-resource settings, including the number of skilled birth attendants required for safe and respectful births.

Short-term evaluation of immune levels and nutritional values of EN versus PN in gastric cancer: a systematic review and a meta-analysis.

BACKGROUND: Postsurgical patients' oral feeding begins with clear fluids 1-3 days after surgery. This might not be sufficiently nutritious to boost the host immune system and provide sufficient energy in gastric neoplastic patients to achieve the goal of enhanced recovery after surgery (ERAS). Our objective was to analyze the significance of early postoperative feeding tubes in boosting patients' immunity and decreasing incidence of overall complications and hospital stay in gastric cancer patients' post-gastrectomy. METHODS: From January 2005 to May 24, 2019, PubMed and Cochrane databases were searched for studies involving enteral nutrition (EN) feeding tubes in comparison to parenteral nutrition (PN) in gastric cancer patients undergoing gastrectomy for gastric malignancies. Relative risk (RR), mean difference (MD), or standard mean difference (SMD) with 95% confidence interval (CI) were used to estimate the effect sizes, and heterogeneity was assessed by using Q and χ2 statistic with their corresponding P values. All the analyses were performed with Review Manager 5.3 and SPSS version 22. RESULTS: Nine randomized trials (n = 1437) and 5 retrospective studies (n = 421) comparing EN feeding tubes and PN were deemed eligible for the pooled analyses, with a categorized time frame of PODs ≥ 7 and PODs < 7. Ratio of CD4+/CD8+ in EN feeding tubes was the only outcome of PODs < 7, which showed significance (MD 0.22, 95% CI 0.18-0.25, P < 0.00001). Regarding other immune indicators, significant outcomes in favor of EN feeding tubes were measured on POD ≥ 7: CD3+ (SMD 1.71; 95% CI 0.70, 2.72; P = 0.0009), CD4+ (MD 5.84; 95% CI 4.19, 7.50; P < 0.00001), CD4+/CD8+ (MD 0.28; 95% CI 0.20; 0.36, P < 0.00001), NK cells (SMD 0.94; 95% CI 0.54, 1.30; P < 0.00001), nutrition values, albumin (SMD 0.63; 95% CI 0.34, 0.91; P < 0.001), prealbumin (SMD 1.00; 95% CI 0.52, 1.48; P < 0.00001), and overall complications (risk ratio 0.73 M-H; fixed; 95% CI 0.58, 0.92; P = 0.006). CONCLUSION: EN feeding tube support is an essential intervention to elevate patients' immunity, depress levels of inflammation, and reduce the risk of complications after gastrectomy for gastric cancer. Enteral nutrition improves the innate immune system and nutrition levels but has no marked significance on certain clinical outcomes. Also, EN reduces the duration of hospital stay and cost, significantly.

Toxicological evaluation of subchronic use of pioglitazone in mice.

OBJECTIVES: Pioglitazone (Actos) is one of the most controversial recent oral antidiabetic drugs. It was originally authorized in the European Union in 2000, and approved as an oral monotherapy for overweight second type of diabetic patients in 2002. It belongs to the thiazolidinedione group which some of its members have been withdrawn from the market due to the hepatotoxicity or cardiotoxicity effects. This study investigates sub-chronic use of pioglitazone induced toxicity in mice by the assessment of renal and liver function tests, cardiac enzymes, and some hematological indices with histological changes of liver, kidney, heart, and bladder. MATERIALS AND METHODS: 120 albino mice were divided into four groups; 30 in each. The first group (control) received water, second (diabetic) group received alloxan only, while the third and the fourth groups received alloxan with 200 and 400 mg/kg/day of pioglitazone, respectively for 90 days. RESULTS: Prolonged use of pioglitazone induced significant abnormalities of hepatic, renal, and cardiac biomarkers and some hematological indices associated with histopathological changes in the liver, kidney, heart, and bladder that increased based on administered dose. CONCLUSION: Subchronic use of pioglitazone leads to hepatic, renal, cardiac, hematological, and bladder affection depending on the applied dose.

Comparison between the protective effects of vitamin K and vitamin A on the modulation of hypervitaminosis D3 short-term toxicity in adult albino rats.

BACKGROUND/AIM: Vitamin D3 has increased risk of toxicity due to its common use in multivitamin preparations. Vitamin K and vitamin A play an important role in vitamin D action. The goal of the current study was to compare the protective effects of vitamin K and vitamin A on the modulation of hypervitaminosis D3 toxicity in rats by assessing serum calcium, renal function tests, cardiac enzymes, and related histopathological changes. MATERIALS AND METHODS: Eighty adult albino rats were divided into four groups; each group consisted of 20 rats. The first group received water; the second received a toxic dose of vitamin D3; the third received a toxic dose of vitamin D3 with vitamin A; and the fourth received a toxic dose of vitamin D3 with vitamin K. RESULTS: Vitamin D3 toxicity led to significant abnormalities of cardiac enzymes, renal function tests, and serum calcium associated with histopathological changes in the kidney, heart, lung, adrenal gland, and aorta. Individual administration of vitamin A or vitamin K with a toxic dose of vitamin D improved the biochemical and histopathological abnormalities of hypervitaminosis D3. CONCLUSION: Vitamins A and K showed the same protective effects in the modulation of hypervitaminosis D3 short-term toxicity.

Curcumin improves atorvastatin-induced myotoxicity in rats: Histopathological and biochemical evidence.

Atorvastatin is considered to be one of the most commonly used of all statins anti-hyperlipidemic drugs despite the fact that there is much controversy about its safety. Its therapeutic use becomes severely limited by the hazards of inducing myotoxicity. Curcumin is one of the safe spices that have chemoprotection and cytoprotection effects against endogenous and exogenous noxious stimuli. This study investigates the effect of curcumin on atorvastatin sub-chronic use-induced myotoxicity in rats by the assessment of serum creatinine phosphokinase, lactic acid dehydrogenase, myoglobin, troponin, potassium, creatinine, and histopathological changes of skeletal, smooth, and cardiac muscles by light and electron microscope examination. Eighty adult albino rats were divided into four groups; each group consists of 20 rats. The control group received water, the second group received atorvastatin, the third group received curcumin, and the fourth group received curcumin with atorvastatin for 90 days by gastric gavage. The prolonged use of atorvastatin induced significant abnormalities of all myotoxicity biomarkers associated with histopathological and ultrastructural changes in the different types of the muscles. Co-administration of curcumin with sub-chronic use of atorvastatin led to an improvement in myotoxicity manifestations.

Histopathological Study of Cyclosporine Pulmonary Toxicity in Rats.

Cyclosporine is considered one of the common worldwide immunosuppressive drugs that are used for allograft rejection prevention. However, articles that address adverse effects of cyclosporine use on the vital organs such as lung are still few. This study aims to investigate pulmonary toxic effect of cyclosporine in rats by assessment of pulmonary histopathological changes using light and electron microscope examination. Sixty male adult albino rats were divided into three groups; each group consists of twenty rats. The first received physiological saline while the second and third groups received 25 and 40 mg/kg/day of cyclosporine, respectively, by gastric gavage for forty-five days. Cyclosporine reduced the lung and body weight with shrinkage or pyknotic nucleus of pneumocyte type II, degeneration of alveoli and interalveolar septum beside microvilli on the alveolar surface, emphysema, inflammatory cellular infiltration, pulmonary blood vessels congestion, and increase of fibrous tissues in the interstitial tissues and around alveoli with negative Periodic Acid-Schiff staining. Prolonged use of cyclosporine induced pulmonary ultrastructural and histopathological changes with the lung and body weight reduction depending on its dose.