Cangrelor for neurointerventional procedures: A systematic review.

Thromboembolism is a complication of neurointerventional procedures that requires patients to be placed under antiplatelet therapy. Current options for antiplatelet therapies have a delayed onset of action that prevents a rapid door to puncture transition for patents presenting in acute settings. Cangrelor (Kengreal, Chiesi, USA) is an intravenous P2Y12 platelet inhibitor approved in percutaneous coronary interventions that has an immediate onset of action and half-life between 2 and 6 min. Thus, the goal of this study is to report on the safety, effectiveness, and indications for using Cangrelor in neurointerventional procedures. A systematic review of studies describing the use of Cangrelor in neurointervention was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was conducted on PubMed, Ovid Medline, and Embase databases through June 2023. Seventeen studies with 314 patients met inclusion criteria. The most common indication for Cangrelor use was acute ischemic strokes: 70% followed by aneurysms 27.4%. The Infusion protocol varied from 5 to 30 µg/kg bolus and 1 to 4 µg/kg/min infusion with 30 µg/kg bolus and 4 µg/kg/min infusion being reported in 64.7% of studies. Intra-operative platelet reacting unit levels were below 200 in all the studies that reported it, and the percentage of hemorrhagic, thromboembolic, and deaths occurrence in this patient cohort was respectively 11.1%, 4.8%, and 8.6%. Cangrelor appears to be a promising P2Y12 platelet inhibitor for neurointerventional procedures. However, large, randomized trials are needed to determine the full range of its effects in neurointerventional procedures.

Synthesis, characterization, and BSA binding studies of newfangled 2-phenylacetohydrazide derivatives.

Five 2-phenylacetohydrazide derivatives (BPAH = N'-benzylidene-2-phenylacetohydrazide, HBPAH = N'-(2-hydroxybenzylidene)-2-phenylacetohydrazide), PPAH = 2-phenyl-N'-3-phenylallylideneacetohydrazide, FMPAH = N'-(furan-2-ylmethylene)-2-phenylaceto hydrazide and EPAH = N'-ethylidene-2-phenylacetohydrazide were synthesized by the condensation of 2-phenylacetohydrazide with the corresponding aldehyde. The synthesized compounds were characterized by FTIR, 1D, and 2D NMR spectroscopy. The structure of the BPAH and PPAH were analyzed by single crystal X-ray diffraction analysis and in both crystallized compounds, the molecules adopted trans geometry around the -C[bond, double bond]N- (imine) functional group. To explore the pharmacological significance of these compounds, the binding ability of these compounds with Bovine Serum Albumin (BSA) was investigated using fluorescence spectroscopy. BPAH and PPAH showed the highest binding ability while EPAH, HBPAH, and FMPAH had lower binding ability to BSA molecules. Thermodynamic parameters ΔG, ΔH°, and ΔS° demonstrated that interactions of BSA with compounds BPAH, EPAH, FMAH, and HBPAH were exothermic while for PPAH it was endothermic. The negative enthalpy and entropy of the compounds BPAH, EPAH, FMAH, and HBPAH indicated that van der Waals' forces and hydrogen bonding played a major role in stabilizing the BSA binding with the molecules. Hydrophobic interactions were predominant in the binding of PPAH with BSA tends to interact with two sets of BSA binding sites with an increase in temperature.

Relation of poverty with treatment-seeking behavior and antibiotic misuse among UTI patients in Pakistan.

Objective: The current study aimed to assess the relation between multi-dimension poverty, treatment-seeking behavior, and antibiotic misuse among urinary tract infection (UTI) patients. Method: A cross-sectional approach was utilized to recruit patients who had a history of UTI in the previous month from two provinces of Pakistan. The treatment-seeking behavior and antibiotic misuse data were collected on a self-developed questionnaire, whereas the poverty data were collected on a modified multi-dimension poverty index (MPI). Descriptive statistics were applied to summarize the data. The logistic regression analysis was carried out to assess the association of multi-dimension poverty with patient treatment-seeking behavior and antibiotic misuse. Results: A total of 461 participants who had UTI symptoms in the previous month were recruited. Most of the participants in the severely deprived stage treated the UTI (p < 0.001); however, there was a high proportion of the participants who consulted with friends and family for UTI treatment (p < 0.001). The patients with deprivation status (deprived and severely deprived) were less associated with formal consultation. The poorer subgroups were less likely to practice antibiotic course completion. Conclusion: The current study highlighted that poverty plays an important role in antibiotic misuse. Poorer subgroups were associated with informal consultations and the incompletion of the antibiotic course. Further studies are needed to explore the potential role of poverty in treatment-seeking behavior and antibiotic misuse.

Integrated AI-driven optimization of Fenton process for the treatment of antibiotic sulfamethoxazole: Insights into mechanistic approach.

Antibiotics, as a class of environmental pollutants, pose a significant challenge due to their persistent nature and resistance to easy degradation. This study delves into modeling and optimizing conventional Fenton degradation of antibiotic sulfamethoxazole (SMX) and total organic carbon (TOC) under varying levels of H2O2, Fe2+ concentration, pH, and temperature removal using both statistical and artificial intelligence techniques including Multiple Regression Analysis (MRA), Support Vector Regression (SVR) and Artificial Neural Network (ANN). In statistical analysis, ANN model showcased an elevated predictive accuracy compared to its counterparts due to having lowest RMSE values of 0.986 and 1.173 for both SMX and TOC, respectively. Sensitivity showcased H2O2/Fe2+ ratio, time and pH as pivotal for SMX degradation, while in simultaneous SMX and TOC reduction, fine tuning the time, pH, and temperature was essential. Leveraging a Hybrid Genetic Algorithm-Desirability Optimization approach, the trained ANN model revealed an optimal desirability of 0.941 out of 1000 solutions which yielded a 91.18% SMX degradation and 87.90% TOC removal under following specific conditions: treatment time of 48.5 min, Fe2+: 7.05 mg L-1, H2O2: 128.82 mg L-1, pH: 5.1, initial SMX: 97.6 mg L-1, and a temperature: 29.8 °C. LC/MS analysis reveals multiple intermediates with higher m/z (242, 270 and 288) and lower m/z (98, 108, 156 and 173) values identified, however no aliphatic hydrocarbon was isolated, because of the low mineralization performance of Fenton process. Furthermore, some inorganic fragments like NH4+ and NO3- were also determined in solution. This comprehensive research enriches AI modeling for intricate Fenton-based contaminant degradation, advancing sustainable antibiotic removal strategies.

Design, synthesis, biological evaluation and molecular docking studies of quinoline-anthranilic acid hybrids as potent anti-inflammatory drugs.

Despite the high global prevalence, rheumatoid arthritis lacks a satisfactory treatment. Hence, the present study is undertaken to design and synthesize novel anti-inflammatory compounds. For this, quinoline and anthranilic acid, two medicinally-privileged moieties, were linked by pharmacophore hybridization, and following their computational assessments, three hybrids 5a-c were synthesized in good over all yields. The in vitro and in vivo anti-inflammatory potential of these hybrids was determined by anti-denaturation and anti-proteinase, and carrageenan-induced paw edema models. The computational studies of these hybrids revealed their drug-likeness, optimum pharmacokinetics, and less toxicity. Moreover, they demonstrated high binding affinity (-9.4 to -10.6 kcal mol-1) and suitable binding interactions for TNF-α, FLAP, and COX-II. A three-step synthetic route resulted in the hybrids 5a-c with 83-86% yield of final step. At 50 µg mL-1, the antiprotease and anti-denaturation activity of compound 5b was significantly higher than 5a and 5c. Furthermore, 5b significantly reduced the edema in the right paw of the rats that received carrageenan. The results of this study indicate the medicinal worth of the novel hybrids in treating inflammatory disorders such as rheumatoid arthritis.

Neuro-computing solution for Lorenz differential equations through artificial neural networks integrated with PSO-NNA hybrid meta-heuristic algorithms: a comparative study.

In this article, examine the performance of a physics informed neural networks (PINN) intelligent approach for predicting the solution of non-linear Lorenz differential equations. The main focus resides in the realm of leveraging unsupervised machine learning for the prediction of the Lorenz differential equation associated particle swarm optimization (PSO) hybridization with the neural networks algorithm (NNA) as ANN-PSO-NNA. In particular embark on a comprehensive comparative analysis employing the Lorenz differential equation for proposed approach as test case. The nonlinear Lorenz differential equations stand as a quintessential chaotic system, widely utilized in scientific investigations and behavior of dynamics system. The validation of physics informed neural network (PINN) methodology expands to via multiple independent runs, allowing evaluating the performance of the proposed ANN-PSO-NNA algorithms. Additionally, explore into a comprehensive statistical analysis inclusive metrics including minimum (min), maximum (max), average, standard deviation (S.D) values, and mean squared error (MSE). This evaluation provides found observation into the adeptness of proposed AN-PSO-NNA hybridization approach across multiple runs, ultimately improving the understanding of its utility and efficiency.

A novel methodology for stabilization of silver nanoparticles on cotton, nylon and cotton/nylon fabrics using chitosan and triethyl orthoformate for enhanced and elongated antibacterial performance.

In the present study, the commercially available three different fabrics cotton, nylon and cotton/nylon were modified by chitosan and silver nanoparticles using a crosslinker triethyl orthoformate (TEOF). Resulted cotton­silver (Ag-Cs-Cot), nylon­silver (Ag-Cs-Nyl) and cotton-nylon silver (Ag-Cs-Cot-Nyl) fabrics showed significant anti-bacterial activity even after 50 washing cycles. Silver nanoparticles were prepared by reducing silver nitrate through sodium borohydride at 0 °C. In FTIR spectra the peak at near 1650 cm-1 confirmed that TEOF mediated attachment of chitosan with fabrics (due to C=N) and the stretching of secondary amine near the 3375 cm-1 indicated the silver attachment to the amine group of the chitosan. In Scanning Electron Microscope (SEM) images smooth surfaces of fabrics without any damage by modification process were observed. The antibacterial activity was Analyzed by agar diffusion and broth dilution assays against Escherichia coli and Staphylococcus aureus bacterial strains and results showed 90% bacterial inhibition against E. coli and 89% bacterial inhibition against S. aureus. For testing the antibacterial durability, the modified fabrics were washed with non-ionic detergent (10g/l) for 15 minutes under aggressive stirring (100 rpm) at room temperature. The modified fabrics retained antibacterial activity over the 50 washing cycles. Finally, the commercial potential of cotton-silver fabric was evaluated by stitching it with the socks of football players and interestingly results showed that the modified fabric on the socks showed more than 90% bacterial inhibition as compared to the plain fabric after 70 minutes of playing activity.

From instable directional switching to controlled unidirectional operation in a nonlinear fiber ring laser.

We investigate a new phenomenon, where a reciprocal fiber ring laser switches from bidirectional to unidirectional operation above a certain pump power threshold. Significant simplifications regarding earlier experiments are presented, which for the first time allow the identification of individual nonlinear effects. We highlight the unique role of stimulated Raman scattering in triggering unidirectional operation, and that additional conditions apply. The threshold is reduced from 30 to 3.8 W, which eases potential applications.

Access authentication via blockchain in space information network.

Space Information Network (SIN) has significant benefits of providing communication anywhere at any time. This feature offers an innovative way for conventional wireless customers to access enhanced internet services by using SIN. However, SIN's characteristics, such as naked links and maximum signal latency, make it difficult to design efficient security and routing protocols, etc. Similarly, existing SIN authentication techniques can't satisfy all of the essentials for secure communication, such as privacy leaks or rising authentication latency. The article aims to develop a novel blockchain-based access authentication mechanism for SIN. The proposed scheme uses a blockchain application, which has offered anonymity to mobile users while considering the satellites' limited processing capacity. The proposed scheme uses a blockchain application, which offers anonymity to mobile users while considering the satellites' limited processing capacity. The SIN gains the likelihood of far greater computational capacity devices as technology evolves. Since authenticating in SIN, the technique comprises three entities: low Earth orbit, mobile user, and network control centre. The proposed mutual authentication mechanism avoids the requirement of a ground station, resulting in less latency and overhead during mobile user authentication. Finally, the new blockchain-based authentication approach is being evaluated with AVISPA, a formal security tool. The simulation and performance study results illustrate that the proposed technique delivers efficient security characteristics such as low authentication latency, minimal signal overhead and less computational cost with group authentication.

Trans-Nasal Endoscopic Repair of CSF Rhinorrhea: An Institutional Experience.

Introduction: Cerebrospinal Fluid (CSF) rhinorrhea results from breakdown in the integrity of structures separating the subarachnoid space and nasal cavity, namely subarachnoid space and dura mater, the bony skull base and periostea alongside the upper aerodigestive tract mucosa. Endoscopic repair is considered the treatment of choice for CSF rhinorrhea. Our aim of study was to analyze the etiopathogenesis and outcomes of treatment. Material and Methods: A retrospective study review of patients treated with endoscopic repair of CSF rhinorrhea at tertiary care hospital in ENT Department Benazir Bhutto hospital Rawalpindi from august 2013 to September 2017 identified 25 patients. Majority of them were male. The defects were closed in three layers using fat, fascia lata and nasal mucosa along with fibrin sealant in majority of patients. Pre operatively subarachnoid drain was placed in all patients. Patients were followed up to 3 months. Results: Forty-four patients underwent endoscopic repair of CSF rhinorrhea. The age group ranged from 16 to 55 years. Of the total of 44 patients 26 (59%) were males and 18(41%) females. The mean age of the patients in our study was 32.8 ± 9.7. Post trauma CSF leak was seen up to 52.3% of the patients. The most common site of leakage was identified Cribriform plate area. Our success rate of endoscopic repair was 88.6%. The most commonly observed complication was meningitis that was observed in 2 (4.5%) of the patients that too were managed conservatively. Conclusion: Accurate localization of site of leakage appears to be essential for successful endoscopic repair of CSF rhinorrhea. In our study cribriform plate area was commonly observed area of CSF leak. In our study, the success rate was 88.6% and low complication rate 4.5%.

A study protocol for integrating outpatient services at the primary health care level as part of the universal health coverage benefit package within the national health insurance program of Pakistan through private health facilities.

Introduction and aim: Pakistan has a mixed-health system where up to 60% of health expenditures are out of pocket. Almost 80% of primary healthcare (PHC) facilities are in the private sector, which is deeply embedded within the country's health system and may account for the unaffordability of healthcare. Since 2016, the existing national health insurance program or Sehat Sahulat Program (SSP), has provided invaluable coverage and financial protection to the millions of low-income families living in Pakistan by providing inpatient services at secondary and tertiary levels. However, a key gap is the non-inclusion of outpatient services at the PHC in the insurance scheme. This study aims to engage a private provider network of general practitioners in select union councils of Islamabad Capital Authority (ICT) of Pakistan to improve access, uptake, and satisfaction and reduce out-of-pocket expenditure on quality outpatient services at the PHC level, including family planning and reproductive health services. Methods and analysis: A 24-month research study is proposed with a 12-month intervention period using a mixed method, two-arm, prospective, quasi-experimental controlled before and after design with a sample of 863 beneficiary families from each study arm, i.e., intervention and control groups (N = 1726) will be selected through randomization at the selected beneficiary family/household level from four peri-urban Union Councils of ICT where no public sector PHC-level facility exists. All ethical considerations will be assured, along with quality assurance strategies. Quantitative pre/post surveys and third-party monitoring are proposed to measure the intervention outcomes. Qualitative inquiry with beneficiaries, general practitioners and policymakers will assess their knowledge and practices. Conclusion and knowledge contribution: PHC should be the first point of contact for accessing health services and appears to serve as a programmatic engine for universal health coverage (UHC). The research aims to study a service delivery model which harnesses the private sector to deliver an essential package of health services as outpatient services under SSP, ultimately facilitating UHC. Findings will provide a blueprint referral system to reduce unnecessary hospital admissions and improve timely access to healthcare. A robust PHC system can improve population health, lower healthcare expenditure, strengthen the healthcare system, and ultimately make UHC a reality.

The groundbreaking impact of digitalization and artificial intelligence in sheep farming.

The integration of digitalization and Artificial Intelligence (AI) has marked the onset of a new era of efficient sheep farming in multiple aspects ranging from the general well-being of sheep to advanced web-based management applications. The resultant improvement in sheep health and consequently better farming yield has already started to benefit both farmers and veterinarians. The predictive analytical models embedded with machine learning (giving sense to machines) has helped better decision-making and has enabled farmers to derive most out of their farms. This is evident in the ability of farmers to remotely monitor livestock health by wearable devices that keep track of animal vital signs and behaviour. Additionally, veterinarians now employ advanced AI-based diagnostics for efficient parasite detection and control. Overall, digitalization and AI have completely transformed traditional farming practices in livestock animals. However, there is a pressing need to optimize digital sheep farming, allowing sheep farmers to appreciate and adopt these innovative systems. To fill this gap, this review aims to provide available digital and AI-based systems designed to aid precision farming of sheep, offering an up-to-date understanding on the subject. Various contemporary techniques, such as sky shepherding, virtual fencing, advanced parasite detection, automated counting and behaviour tracking, anomaly detection, precision nutrition, breeding support, and several mobile-based management applications are currently being utilized in sheep farms and appear to be promising. Although artificial intelligence and machine learning may represent key features in the sustainable development of sheep farming, they present numerous challenges in application.

A retrospective study on weaning glucocorticoids and recovery of the hypothalamic-pituitary-adrenal axis.

CONTEXT: Glucocorticoids suppress the hypothalamic-pituitary-adrenal (HPA) axis resulting in tertiary adrenal insufficiency (AI). When weaning patients off glucocorticoids there is no consensus on whether to maintain patients on prednisolone or convert to hydrocortisone. OBJECTIVE: Investigate HPA axis recovery in patients on long-term prednisolone and assess outcome after hydrocortisone conversion. DESIGN: Retrospective cohort study. SETTING: Outpatient endocrine steroid clinic. PATIENTS: Patients on long-term prednisolone referred for HPA axis testing between 2015-2022. MAIN OUTCOMES MEASURED: 1) HPA axis recovery rate in patients on prednisolone demonstrated by normal ACTH stimulation test (AST).2) HPA axis recovery rate sub-analysis of dose-matched patients with confirmed tertiary AI on prednisolone or hydrocortisone. RESULTS: 206 patients on prednisolone were tested for tertiary AI. Of these 176 remained on prednisolone while 30 were converted to hydrocortisone. The overall HPA axis recovery rate for patients on prednisolone after interval testing was 137/206 (66.5%). HPA axis recovery rate in dose-matched prednisolone and hydrocortisone conversion groups was 7/10 (70%) and 2/13 (15%) (p=0.008), respectively. There was no difference in mean (SD) age (67.1(12.2) v 63.4(11.1) years; p=0.464) and baseline cortisol (5.3(4.2) v 4.6(3.1)µg/dL; p=0.648) and median [IQR] glucocorticoids duration (1213[1114] v 2316[4808] days; p=0.693) and baseline ACTH (20.5[29.0] v 16.3[14.8]ng/L; p=0.905) between dose-matched prednisolone and hydrocortisone groups. Follow-up duration in prednisolone group was significantly lower (median [IQR] 348[975] v 667[884] days; p=0.012). CONCLUSIONS: Patients with glucocorticoid induced AI maintained on once-daily prednisolone can recover HPA axis function when weaning. There is no apparent advantage to recover HPA axis function in converting to multiple dosing hydrocortisone.

A Systematic Review of the Economic Burden of Diabetes in Eastern Mediterranean Region Countries.

Diabetes Mellitus (DM) is a highly prevalent non-communicable disease with high mortality and morbidity, which imposes a significant financial impact on individuals and the healthcare system. The identification of various cost components through cost of illness analysis could be helpful in health-care policymaking. The current systematic review aims to summarize the economic burden of DM in the Eastern Mediterranean Region (EMR) countries. The original studies published in the English language between January 2010 and June 2023 reported the cost of DM was identified by searching four different databases (Google Scholar, PubMed, Science Direct, and Cochrane Central). Two reviewers independently screened the search results and extracted the data according to a predefined format, whereas the third reviewer's opinion was sought to resolve any discrepancies. The costs of DM reported in the included studies were converted to USD dates reported in the studies. After the systematic search and screening process, only 10 articles from EMR countries met the eligibility criteria to be included in the study. There are substantial variations in the reported costs of DM and the methodologies used in the included studies. The mean annual cost per patient of DM (both direct and indirect cost) ranged from 555.20 USD to 1707.40 USD. The average annual direct cost ranged from 155.8 USD to 5200 USD and indirect cost ranged from 93.65 USD to 864.8 USD per patient. The studies included in the review obtained a median score of 8.65 (6.5 ─ 11.5) on the quality assessment tool based on Alison's checklist for evaluation of cost of illness studies. There is a significant economic burden associated with DM, which directly affects the patients and healthcare system. Future research should focus on refining cost estimation methodologies, improving the understanding of study findings, and making it easier to compare studies.

Investigating the Impact of Carbon Nanotube Nanoparticle Exposure on Testicular Oxidative Stress and Histopathological Changes in Swiss albino Mice.

Carbon nanotubes (CNTs) possess remarkable properties that make them valuable for various industrial applications. However, concerns have arisen regarding their potential adverse health effects, particularly in occupational settings. The main aim of this research was to examine the effects of short-term exposure to multiwalled carbon nanotube nanoparticles (MWCNT-NPs) on testicular oxidative stress in Swiss albino mice, taking into account various factors such as dosage, duration of exposure, and particle size of MWCNT-NP. In this study, 20 mice were used and placed into six different groups randomly. Four of these groups comprised four repetitions each, while the two groups served as the vehicle control with two repetitions each. The experimental groups received MWCNT-NP treatment, whereas the control group remained untreated. The mice in the experimental groups were exposed to MWCNT-NP for either 7 days or 14 days. Through oral administration, the MWCNT-NP solution was introduced at two distinct dosages: 0.45 and 0.90 µg, whereas the control group was subjected to distilled water rather than the MWCNT-NP solution. The investigation evaluated primary oxidative balance indicators-glutathione (GSH) and glutathione disulfide (GSSG)-in response to MWCNT-NP exposure. Significantly, a noticeable reduction in GSH levels and a concurrent increase in GSSG concentrations were observed in comparison to the control group. To better understand and explore the assessment of the redox status, the Nernst equation was used to calculate the redox potential. Intriguingly, the calculated redox potential exhibited a negative value, signifying an imbalance in the oxidative state in the testes. These findings suggest that short-term exposure to MWCNT-NP can lead to the initiation of testicular oxidative stress and may disrupt the male reproductive system. This is evident from the alterations observed in the levels of GSH and GSSG, as well as the negative redox potential. The research offers significant insights into the reproductive effects of exposure to MWCNTs and emphasizes the necessity of assessing oxidative stress in nanomaterial toxicity studies.

Atypical Mycobacterial Infection Mimicking Psoriasis in an Elderly Patient: Diagnostic Challenges and Management.

Atypical mycobacterial infections can have diverse clinical presentations, frequently resulting in diagnostic challenges. This study examines an uncommon atypical mycobacterial disease in an older patient, initially misidentified as psoriasis, emphasizing the difficulties in diagnosing and managing the condition. A 70-year-old male patient arrived at the dermatology department at National Hospital and Medical Centre, Lahore, with a persistent, dry, red rash mainly affecting his arms and legs. The patient had a medical background of diabetes mellitus and hypertension. Initial clinical diagnosis suggested psoriasis based on the appearance and patient's age. The patient was started on conventional psoriatic therapies. However, there was only a slight improvement, which led to the need for additional inquiry. Skin biopsies were conducted, uncovering the presence of granulomatous inflammation. Following cultures and polymerase chain reaction (PCR) tests, the presence of atypical mycobacteria was established. Subsequent laboratory tests eliminated the possibility of tuberculosis (TB) and other prevalent diseases. The conclusive diagnosis was an unusual mycobacterial infection, which posed a challenge due to its clinical similarity to psoriasis. The patient was treated with antibiotics appropriate to the mycobacterial species discovered. The duration of the treatment spanned six months, resulting in a notable amelioration of the skin lesions. The patient is being closely observed for any potential reoccurrence. This case highlights the significance of including atypical mycobacterial infection as a possible diagnosis for persistent dermatological problems, particularly in persons with impaired immune systems. It emphasizes the need for biopsy and culture in unusual situations of suspected psoriasis. This instance also demonstrates the intricacies associated with managing older patients with multiple concurrent medical issues. Unusual mycobacterial infections can imitate conventional skin disorders such as psoriasis, presenting considerable difficulties in diagnosis. Having a strong suspicion and doing relevant laboratory tests are essential for achieving an accurate diagnosis and efficient treatment.

Global health inequalities of chronic kidney disease: a meta-analysis.

BACKGROUND AND HYPOTHESIS: Chronic kidney disease (CKD) is a significant contributor to global morbidity and mortality. This study investigated disparities in age, sex and socio-economic status in CKD and updated global prevalence estimates through systematic review and meta-analysis. METHODS: Five databases were searched from 2014 to 2022, with 14 871 articles screened, 119 papers included and data analysed on 29 159 948 participants. Random effects meta-analyses were conducted to determine overall prevalence, prevalence of stages 3-5 and prevalence in males/females. Influences of age, sex and socio-economic status were assessed in subgroup analyses, and risk of bias assessment and meta-regressions were conducted to explore heterogeneity. RESULTS: Overall prevalence of CKD was 13.0% (11.3-14.8%) and 6.6% (5.6-7.8%) for stages 3-5. Prevalence was higher in studies of older populations (19.3% for stages 1-5, 15.0% for stages 3-5) and meta-regression demonstrated association of age, body mass index, diabetes and hypertension with prevalence of stages 3-5. The prevalence of CKD stages 1-5 was similar in males and females (13.1% versus 13.2%) but prevalence of stages 3-5 was higher in females (6.4% versus 7.5%). Overall prevalence was 11.4%, 15.0% and 10.8% in low, middle and high-income countries respectively; for stages 3-5 prevalence was 4.0%, 6.7% and 6.8%, respectively. Included studies were at moderate-high risk of bias in the majority of cases (92%), and heterogeneity was high. CONCLUSION: This study provides a comprehensive assessment of CKD prevalence, highlighting important disparities related to age, sex and socio-economic status. Future research should focus on targeted screening and treatment approaches, improving access to care and more effective data monitoring, particularly in low or middle income countries.

Integrating DFT and machine learning for the design and optimization of sodium alginate-based hydrogel adsorbents: Efficient removal of pollutants from wastewater.

This study presents a novel approach to design and optimize a sodium alginate-based hydrogel (SAH) for efficient adsorption of the model water pollutant methylene blue (MB) dye. Utilizing density functional theory (DFT) calculations, sodium alginate-g-poly (acrylamide-co-itaconic acid) was identified with the lowest adsorption energy (Eads) for MB dye among 14 different clusters. SAHs were prepared using selected monomers and sodium alginate combinations through graft co-polymerization, and swelling studies were conducted to optimize grafting conditions. Advanced characterization techniques, including FTIR, XRD, XPS, SEM, EDS, and TGA, were employed, and the process was optimized using statistical and machine learning tools. Screening tests demonstrated that Eads serves as an effective predicting indicator for adsorption capacity (qe) and MB removal efficiency (RRMB,%), with reasonable agreement between Eads and both responses under given conditions. Process modeling and optimization revealed that 5 mg of selected SAH achieves a maximum qe of 3244 mg g-1 at 84.4% RRMB under pH 8.05, 98.8 min, and MB concentration of 383.3 mg L-1, as identified by the desirability function approach. Moreover, SAH effectively eliminated various contaminants from aqueous solutions, including sulfasalazine (SFZ) and dibenzothiophene (DBT). MB adsorption onto selected SAH was exothermic, spontaneous, and followed the pseudo-first-order and Langmuir-Freundlich isotherm models. The remarkable ability of SAH to adsorb MB is attributed to its well-designed structure predicted through DFT and optimal operational conditions achieved by AI-based parametric optimization. By integrating DFT-based computations and machine-learning tools, this study contributes to the efficient design of adsorbent materials and optimization of adsorption processes, also showcasing the potential of SAH as an efficient adsorbent for the abatement of aqueous pollution.