Sustainable valorization of sugarcane residues: Efficient deconstruction strategies for fuels and chemicals production.

The global climate crisis and the ongoing increase in fossil-based fuels have led to an alternative solution of using biomass for fuel production. Sugarcane bagasse (SCB) is an agricultural residue with a global production of more than 100 million metric tons and it has various applications in a biorefinery concept. This review brings forth the composition, life cycle assessment, and various pretreatments for the deconstruction techniques of SCB for the production of valuable products. The ongoing research in the production of biofuels, biogas, and electricity utilizing the bagasse was elucidated. SCB is used in the production of carboxymethyl cellulose, pigment, lactic acid, levulinic acid, and xylooligosaccharides and it has prospective in meeting the demand for global energy and environmental sustainability.

Health Related Quality of Life of Caregivers of Children and Adolescents With Phenylketonuria: A Systematic Review.

Introduction. Caregivers of children with chronic illness are at risk of having impairment in their quality of life (QOL). We systematically reviewed the available literature related to the Health Related Quality Of Life (HRQOL) of caregivers of children with Phenylketonuria (PKU). Methods. We comprehensively searched in electronic databases including Scopus, Science Direct, CINAHL, Medline, PubMed, Google scholar, and ProQuest. The search criteria included studies with samples more than one, children suffering from PKU, exploring parents or primary caregiver's HRQOL, published from 2010 to 2020, full article available for download and published in English. Eight studies including 5 cross sectional studies, 1 open label trial, and 2 surveys were systematically reviewed. Results. Seven out of 8 studies have established a negative correlation between PKU and parent's HRQOL in at least 1 of the domains. In one study, the HRQOL of parents is higher than their population norms. Conclusion. Most of the caregivers had poor to moderate HRQOL. More studies are required to explore HRQOL of caregivers of children with PKU using similar tools and outcome measures addressing all the domains of HRQOL in order to have more clarity on the impact of PKU on caregiver's HRQOL. Interventional studies might help in improving the HRQOL of caregivers.

Bacterial nanocellulose: engineering, production, and applications.

Bacterial nanocellulose (BNC) has been emerging as a biomaterial of considerable significance in a number of industrial sectors because of its remarkable physico-chemical and biological characteristics. High capital expenses, manufacturing costs, and a paucity of some well-scalable methods, all of which lead to low BNC output in commercial scale, are major barriers that must be addressed. Advances in production methods, including bioreactor technologies, static intermittent, and semi-continuous fed batch technologies, and innovative outlay substrates, may be able to overcome the challenges to BNC production at the industrial scale. The novelty of this review is that it highlights genetic modification possibilities in BNC production to overcome existing impediments and open up viable routes for large-scale production, suitable for real-world applications. This review focuses on various production routes of BNC, its properties, and applications, especially the major advancement in food, personal care, biomedical and electronic industries.

Potential of nanocellulose for wastewater treatment.

Wastewater management has significant interest worldwide to establish viable treatment techniques to ensure the availability of clean water. The specialities of nanocellulose for this particular application is due to their high aspect ratio and accessibility of plenty of -OH groups for binding with dyes, heavy metals and other pollutants. This review aggregates the application of nanocellulose for wastewater treatment particularly as adsorbents of dyes and heavy metals, and also as membranes for filtering various other contaminants including microbes. The membrane technologies are proven to be effective relating to their durability and separation effectiveness. The commercial scale application of nanocellulose based materials in water treatment processes depend on various factors like routes of synthesis, surface modifications, hydrophilic/hydrophobic, porosity, durability etc. The recent developments on production of novel adsorbents or membranes encourage the implementation of nanocellulose based cleaner technologies for wastewater treatment.

Starch modified alginate nanoparticles for drug delivery application.

Natural polymers have been widely studied as vehicles that have gained much interest in the encapsulation and delivery of drugs and bioactive molecules. In this study, we developed starch-modified alginate nanoparticles using a green facile technique for drug delivery application. The potential of the prepared nanoparticles for controlled drug delivery applications is demonstrated using theophylline and bovine serum albumin as model drugs. The nanoparticles possessed the encapsulation efficiency of 60 to 75%. The results of in vitro drug release studies showed the pH dependent characteristics of the prepared nanoparticles. In vitro cytotoxicity test revealed the biocompatibility of the developed nanoparticles against L929 fibroblast cell lines. The in vitro cellular uptake of nanoparticles was visualized in L929 fibroblast cells using fluorescent microscopy. The preliminary investigation suggests the developed nanoparticle is a promising candidate for drug delivery application.

Preparation and evaluation of alginate nanoparticles prepared by green method for drug delivery applications.

Nanosized natural polymers have attained considerable attention in drug delivery applications due to their high encapsulation efficiency, non-toxic nature, sustained and targeted drug delivery. Here we have synthesized Rifampicin loaded alginate nanoparticles by green method. Physicochemical characterization of the nanoparticles was assessed using Transmission electron microscopy, Fourier transform infrared spectroscopy, Dynamic light scattering and X-ray diffraction technique. The swelling and in vitro drug release showed that the framework experiences pH-dependent swelling and release of Rifampicin. Rifampicin has lower release in acid medium and higher release in intestinal condition. Moreover, in view of the drug release results, the release kinetics and transport mechanisms were investigated and discussed. In vitro cytotoxicity assay demonstrated that the nanoparticles were non-toxic in nature. The acute oral toxicity study of the synthesized nanoparticles was done in Wistar albino rats. No systemic toxicity was observed after oral administration of nanoparticles. The present study demonstrated the potential of using alginate nanoparticles synthesized by a green method for drug delivery applications.

Effectiveness of Nurse Led Intervention on Health Related Quality of Life among Children with Sickle Cell Disease in Oman: A Pilot Study.

Introduction. The children with Sickle Cell Disease (SCD) generally have poor Health Related Quality of Life (HRQOL). The study aimed to evaluate the effectiveness of nurse led intervention on HRQOL among children with SCD. METHODS: A total of 30 samples were selected using convenient sampling. Children with SCD and their caregivers completed Pediatric Quality of Life Inventory (PedsQL) SCD-Module version 3.0. The nurse led intervention was given to the study group for 10 consecutive weeks. The control group received the routine medical care. On completion of 10 weeks, the post-test was conducted. RESULTS: The participants in study group had poor HRQOL scores (P > 0.05) in pre-test. After nurse led intervention, the HRQOL score in the study group significantly improved (P > 0.05) in pre-test. After nurse led intervention, the HRQOL score in the study group significantly improved (Discussion. Therefore nurse led intervention is effective in improving HRQOL among children with SCD.

Parenting a child with metabolic diseases: Impact on health related quality of life of parents.

The study was conducted to assess the health related quality of life of the parents of children with inborn errors of metabolism (IEM). The study was conducted at the Genetic and metabolic outpatient department of Sultan Qaboos University Hospital, Oman. The parents of children with metabolic diseases who were accompanying their children to the outpatient clinics were the samples. An explorative descriptive survey design and Convenient sampling technique were used to select the sample. Study included 72 parents of children with metabolic diseases aged between 20 and 55 years. The RAND 36-Item Health Survey version was used to assess the health related quality of life of parents. The results shows lower mean scores in subscales of 'general health' and vitality. Parents with higher educational levels showed higher levels of PCS and MCS scores than parents with lower educational levels. Parents with higher monthly income and younger age showed higher quality of life. A significant association was found between supporting persons and HQoL in the dimensions of the "role limitations due to physical" (p<0.03), and social functioning (p<0.04). Empowering the parents by helping them to actively seek and maintain social support is an important step in improving the health related quality of life.

Cyperus rotundus L. prevents non-steroidal anti-inflammatory drug-induced gastric mucosal damage by inhibiting oxidative stress.

BACKGROUND: Since centuries, Cyperus rotundus L. has been used against gastric ailments in traditional Indian medicine, especially in Ayurveda and Siddha. Therefore, it is very obvious that this plant will have a greater potential to treat gastric ulcers. For this reason, in this study, we mainly focused on the ulcer-preventive role of C. rotundus in rats treated with non-steroidal anti-inflammatory drugs. METHODS: Seventy percent methanolic extract of the plant was prepared and fed to 36-h fasted rats. Ulcer was induced in these rats by single oral administration of aspirin (400 mg/kg) 1 h after the administration of the plant extract. After 4 h, the rats were sacrificed, ulcer index was calculated, and antioxidant activity of the extract in gastric mucosa was evaluated by determining the levels of superoxide dismutase, glutathione, glutathione peroxidase, and tissue lipid peroxidation. RESULTS: Oral administration of different doses of C. rotundus rhizome methanolic extract (CME; 250 mg/kg and 500 mg/kg) significantly inhibited aspirin-induced gastric ulceration in animals in a dose-dependent manner (49.32% and 53.15%, respectively), which was also comparable with the standard gastric ulcer drug ranitidine. Administration of CME also significantly increased the activity of superoxide dismutase, cellular glutathione and glutathione peroxidase, and inhibited the lipid peroxidation in the gastric mucosa of ulcerated animals in a dose-dependent manner. CONCLUSIONS: Our results showed that C. rotundus extract has the capacity to significantly inhibit aspirin-induced gastric ulcers through an antioxidant defense mechanism. This study warrants further examination of this plant for its gastroprotective activities.

Knowledge of common problems of newborn among primi mothers admitted in a selected hospital for safe confinement.

BACKGROUND: Among the almost 3.9 million newborn deaths that occur worldwide, about 30% occur in India. Children are our future and utmost precious resources. After birth the health of the child depends upon the health care practice adopted by the family, especially by the mothers. Information about neonatal problems and newborn care practices will help in reducing mortality and morbidity during the neonatal period. This study was conducted to identify the knowledge of primi mothers with regard to the common problems of normal neonates. MATERIALS AND METHODS: This descriptive study was carried out among the mothers of neonates in the Maternity Unit of a Medical College Hospital in Mangalore. A pretested structured knowledge questionnaire was used to collect information from 60 primi mothers, who were admitted for safe confinement for a one-month period. RESULTS: The findings of the study show that the majority, that is, 27 (45%) of the primi mothers had a good knowledge of all the areas such as vomiting, regurgitation, diaper rash, umbilical cord infection, fever, constipation, and diarrhea. About 20 (33.3%) had very good knowledge and about 13 (21.67%) had an average level of knowledge on the common problems of newborns. Knowledge about vomiting was average among 34 (56.67%), poor in 21 (35%), and good in five (8.33%). Knowledge about diaper rash was average among 36 (60%), good among 21 (35%), and poor among three (5%). Knowledge on umbilical cord infection was average in 29 (48.33%), good in 27 (45%), and poor in 4 (6.67%). Knowledge on fever was good in 38 (63.33%), average in 19 (31.66%), and poor in three (5%). Knowledge on constipation and diarrhea were average in 38 (63.34%), good in 11 (18.33%), and poor in 11 (18.33%). No association was found between the knowledge of primi mothers and selected baseline variables, such as, age, education, religion, occupation, type of family or area of dwelling. CONCLUSION: The study concludes that there is a need to provide adequate information to first-time mothers about common newborn problems and this will help mothers care for their newborns better.

Assessing clinical learning outcomes: a descriptive study of nursing students in Kuwait.

This study examined the perceptions of 202 nursing students, 14 faculty members, and 32 clinical instructors in the achievement of nursing students' clinical learning outcomes during their different clinical placements. The participants were involved in the bachelor of science in nursing and associate degree in nursing programs. Nine dimensions were studied using the Kuwait Clinical Learning Outcomes for Nursing Students tool. These were knowledge, nursing process, communication, student role, accountability, teaching/learning, organization, caring, and psychomotor skills. The perception of achievement of the clinical learning outcomes was 72% for the students, 77% for the faculty members, and 75% for the clinical instructors. The scores of both the faculty members and the clinical instructors for the student role were significantly higher than the scores of the students. The findings confirmed that the quality and type of clinical placement have a significant impact on the achievement of clinical learning outcomes and provide a strong base for students' development as future professionals.

Factors contributing to nursing task incompletion as perceived by nurses working in Kuwait general hospitals.

BACKGROUND: Unfinished care has a strong relationship with quality of nursing care. Most issues related to tasks incompletion arise from staffing and workload. OBJECTIVES: This study was conducted to assess the workload of nurses, the nursing activities (tasks) nurses commonly performed on medical and surgical wards, elements of nursing care activities left incomplete by nurses during a shift, factors contributing to task incompletion and the relationship between staffing, demographic variables and task incompletion. DESIGN: Exploratory survey using a self-administered questionnaire developed from IHOC survey, USA. PARTICIPANTS: All full time registered nurses working on the general medical and surgical wards of five government general hospitals in Kuwait. METHODS: Research assistants distributed and collected back the questionnaires. Four working days were given to participants to complete and return the questionnaires. A total of 820 questionnaires were distributed and 95% were returned. DATA ANALYSIS: Descriptive and inferential analysis using SPSS-11. RESULTS: The five most frequently performed nursing activities were: administration of medications, assessing patient condition, preparing/updating nursing care plans, close patient monitoring and client health teaching. The most common nursing activities nurses were unable to complete were: comfort talk with patient and family, adequate documentation of nursing care, oral hygiene, routine catheter care and starting or changing IV fluid on time. Tasks were more complete when the nurse-patient load was less than 5. Nurses' age and educational background influenced task completion while nurses' gender had no influence on it. CONCLUSIONS: Increased patient loads, resulting in increased frequency of nursing tasks and non-nursing tasks, were positively correlated to incompletion of nursing activities during the shift. RELEVANCE TO CLINICAL PRACTICE: Emphasis should be given to maintaining the optimum nurse-patient load and decreasing the non-nursing workload of nurses to enhance the quality of nursing care.

Bio-conjugated luminescent quantum dots of doped ZnS: a cyto-friendly system for targeted cancer imaging.

A heavy-metal-free luminescent quantum dot (QD) based on doped zinc sulfide (ZnS), conjugated with a cancer-targeting ligand, folic acid (FA), is presented as a promising bio-friendly system for targeted cancer imaging. Doped QDs were prepared by a simple aqueous method at room temperature. X-ray diffraction and transmission electron microscopy studies showed the formation of monodisperse QDs of average size approximately 4 nm with cubic (sphalerite) crystal structure. Doping of the QDs with metals (Al(3+)), transition metals (Cu(+), Mn(2+)) and halides (F(-)) resulted in multi-color emission with dopant-specific color tunability ranging from blue (480 nm) to red (622 nm). Luminescent centers in doped QDs could be excited using bio-friendly visible light >400 nm by directly populating the dopant centers, leading to bright emission. The cytotoxicity of bare and FA conjugated QDs was tested in vitro using normal lung fibroblast cell line (L929), folate-receptor-positive (FR+) nasopharyngeal epidermoid carcinoma cell line (KB), and FR-negative (FR-) lung cancer cell line (A549). Both bare and FA-conjugated ZnS QDs elicited no apparent toxicity even at high concentrations of approximately 100 microM and 48 h of incubation. In contrast, CdS QDs prepared under identical conditions showed relatively high toxicity even at low concentrations of approximately 0.1 microM and 24 h of incubation. Interaction of FA-QDs with different cell lines showed highly specific attachment of QDs in the FR+ cancer cell line, leaving others unaffected. The bright and stable luminescence of the QDs could be used to image both single cancer cells and colonies of cancer cells without affecting their metabolic activity and morphology. Thus, this study presents, for the first time, the use of non-toxic, Cd-, Te-, Se-, Pb- and Hg-free luminescent QDs for targeted cancer imaging.

Perceived adverse patient outcomes correlated to nurses' workload in medical and surgical wards of selected hospitals in Kuwait.

AIM: This study was carried out to identify the perceived adverse patient outcomes as related to nurses' workload. It also assessed nurses' perception of variables contributing to the workload and adverse patient outcomes. BACKGROUND: Several studies have been published on adverse patient outcomes in which a correlation was found between nurses' workload and some adverse patient outcomes. DESIGN: A cross-sectional survey was conducted between registered nurses (n = 780) working in medical and surgical wards of five general governmental hospitals in Kuwait. DATA COLLECTION INSTRUMENTS: Data were collected using a self-administered questionnaire consisting of three sections to elicit information about the sample characteristics, perception of workload and perceived adverse patient outcomes during the last shift and last working week. RESULTS: The three major perceived adverse outcomes reported by the nurses while on duty during their last shift were: complaints from patients and families (2%), patients received a late dose or missed a dose of medication (1.8%) and occurrences of pressure ulcer (1.5%). Similarly, the reported adverse outcomes over the past week were complaints from patients and families (5%), patients received a late dose or missed a dose of medication (5.3%) and discovery of a urinary tract infection (3.7%). Increases in nurse-patient load, bed occupancy rate, unstable patients' condition, extra ordinary life support efforts and non-nursing tasks; all correlated positively with perceived adverse patient outcomes. CONCLUSION: This study sheds light on an important issue affecting patient safety and quality of care as perceived by the nurses themselves as caregivers. RELEVANCE TO CLINICAL PRACTICE: Nurses' perception of variables contributing to adverse patient outcomes and their workload could significantly affect the provided nursing care and nursing care recipients. The findings could help in policy formulation and planning strategies to decrease adverse patient outcomes in many countries with a health care structure similar to that of Kuwait.

Adverse nurse outcomes: correlation to nurses' workload, staffing, and shift rotation in Kuwaiti hospitals.

This study was conducted to identify adverse outcomes to nurses in relation to their daily patient load, nursing care activities, staffing, and shift rotation. A structured questionnaire was used to collect data from medical and surgical nurses (N = 784). Skipping tea/coffee breaks (95%), feeling responsible for more patients than they could safely care for (87%), inadequate help available (86%), inadequate time to document care (80%), verbal abuse by a patient or a visitor (77%), and concern about quality of care (71%) were the major reported adverse outcomes related to short staffing, increased patient load, and increased nursing care activities.

Health-promoting lifestyle and body mass index among College of Nursing students in Kuwait: a correlational study.

This cross-sectional, descriptive survey of 202 nursing students in Kuwait assessed their body mass index and health-promoting lifestyle to determine any association between them. The body mass index was calculated by dividing the weight by the height squared (kg/m(2)). The health-promoting lifestyle was measured using Walker's Health Promoting Lifestyle Profile II instrument. The participants had a normal body mass index with a tendency towards being overweight and obese, particularly for the males. The students also had a low positive health-promoting lifestyle. A significant association was noted between the sociodemographic variables, particularly age, marital status, and nationality, with the body mass index and Walker's Health Promoting Lifestyle Profile. A significant relationship was established between the body mass index and the overall Walker's Health Promoting Lifestyle Profile and the nutrition subcategory. The findings warranted interventions for improved health behaviors and implied the need for the integration of healthy lifestyle programs into the nursing curricula to meet the escalating demands of the students' role in health promotion and disease prevention.