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BACKGROUND: Research reveals that neonatal pain management in Neonatal Intensive Care Units (NICUs) is suboptimal. There is limited research that assessed NICU nurses' pain assessment practices in Saudi Arabia. AIM: To assess the nurses' pain assessment practices in the NICU in Saudi Arabia. DESIGN: This study used a descriptive cross-sectional design. SETTINGS: Research was conducted using an online survey. PARTICIPANTS/SUBJECTS: This study was carried out on 65 NICU nurses. The participants were recruited from one governmental and one private hospital in Saudi Arabia. METHODS: Data on pain assessment practices were collected, including the frequency of pain assessment, pain assessment scales used for preterm and term neonates, and pain assessment documentation. Data were analyzed using frequencies and percentages. RESULTS: The majority of the participants (94%) routinely assessed pain and documented pain assessment (97%). One-third of the participants assessed pain regularly every hour (32%). The most used pain assessment scales for term neonates were the neonatal infant pain scale (40%) and the cry, required oxygen, increased vital signs, expression, and sleeplessness scale (23%). The most used pain assessment scales for preterm neonates were the neonatal infant pain scale (31%), the cry, required oxygen, increased vital signs, expression, sleeplessness scale (19%), and the premature infant pain profile (17%). CONCLUSIONS: NICU nurses in Saudi Arabia consistently assessed for and documented pain; however, the tools chosen were sometimes suboptimal. A substantial number of NICU nurses used invalid tools to assess pain in term and preterm neonates. An interventional program is needed to enhance the use of evidence-based practice recommendations regarding neonatal pain assessment by nurses in the Neonatal Intensive Care Units in Saudi Arabia.
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Unidades de Terapia Intensiva Neonatal , Medição da Dor , Humanos , Arábia Saudita , Unidades de Terapia Intensiva Neonatal/organização & administração , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Estudos Transversais , Medição da Dor/métodos , Medição da Dor/normas , Recém-Nascido , Feminino , Masculino , Adulto , Inquéritos e Questionários , Manejo da Dor/métodos , Manejo da Dor/normas , Manejo da Dor/estatística & dados numéricos , Enfermagem Neonatal/normas , Enfermagem Neonatal/métodos , Enfermagem Neonatal/estatística & dados numéricosRESUMO
BACKGROUND: There is an increasing rate of Internet addiction among adolescents that may lead to many negative psychological outcomes. This study assessed the relationship between Internet addiction and stress, anxiety, and depression in adolescents in Saudi Arabia. METHODS: A correlational online survey captured data on Internet use and psychological outcomes from 462 adolescents between March and May 2022. Young's Internet Addiction Scale assessed the degree of Internet addiction. The Depression, Anxiety, and Stress Scale (DASS21) assessed the perceived level of stress, anxiety, and depression. Bivariate and multivariate analyses determined the relationship between Internet addiction and depression, anxiety, and stress. RESULTS: Sixty-eight percent of adolescents had mild to severe Internet addiction. Sixty percent of the adolescents perceived mild to extremely severe depression, 58% perceived mild to extremely severe anxiety, and 44% perceived mild to extremely severe stress. Adolescents with more Internet addiction scores perceived more stress, anxiety, and depression (p ≤ 0.05). CONCLUSIONS: The Internet addiction rate is high among adolescents in Saudi Arabia. Adolescents with more Internet addiction scores are prone to perceive higher levels of stress, anxiety, and depression. APPLICATION TO PRACTICE: Interventional multidisciplinary programs are needed to make adolescents, parents, schoolteachers, and school nurses in Saudi Arabia aware of Internet addiction and methods to reduce the dependence of those adolescents on the Internet. School nurses should provide adolescents and parents with means to reduce their Internet dependence.
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Comportamento do Adolescente , Transtorno de Adição à Internet , Estresse Psicológico , Humanos , Adolescente , Arábia Saudita/epidemiologia , Feminino , Masculino , Estresse Psicológico/epidemiologia , Transtorno de Adição à Internet/epidemiologia , Transtorno de Adição à Internet/psicologia , Comportamento do Adolescente/psicologia , Depressão/epidemiologia , Depressão/psicologia , Ansiedade/epidemiologia , Inquéritos e Questionários , Internet , Comportamento Aditivo/psicologia , Comportamento Aditivo/epidemiologiaRESUMO
BACKGROUND: Internet addiction is increasing among adolescents worldwide. There is a lack of research assessing internet addiction and factors contributing to it among adolescents in Jeddah city. The current study aimed to assess the rate of internet addiction among adolescents in Jeddah, Saudi Arabia, and the potential factors associated with it. METHODS: A cross-sectional online survey, hosted by SurveyMonkey, was used to capture data on internet use from 462 adolescents aged 12-18 years between March and May 2022. Young's Internet Addiction Scale was used to assess the degree of internet addiction as perceived by adolescents. Multiple linear regression analysis was used to identify possible predictors of internet addiction among adolescents in Jeddah. RESULTS: The mean age of the participants was 15.5 ± 1.9 years. The majority were females (75%) from public schools (63%), spent an average of six hours on the internet daily, owned smartphones (98%), accessed the internet via a smartphone (94%), and used the internet for socializing (82%). Internet addiction mean score was 39.20 ± 15.20 out of 100. More than two-thirds of the participants had mild to moderate levels of internet addiction (68%). Significant predictors contributing to internet addiction were using the internet for socialization and playing online games. The more hours spent on the internet daily, the more the internet addiction was (p ≤ 0.05). CONCLUSIONS: The internet addiction rate is high among school adolescents in Jeddah. The majority of high school adolescents had mild to moderate levels of internet addiction. Interventional multidisciplinary programs are needed to mitigate the factors that influence internet addiction.
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OBJECTIVES: To evaluate the safety and efficacy of expired lyophilized snake antivenom of Thai origin during a medical emergency in 2020/2021 in Lao People's Democratic Republic. METHODS: Observational case series of patients with potentially life-threatening envenoming who consented to the administration of expired antivenom between August 2020 and May 2022. RESULTS: A total of 31 patients received the expired antivenom. Malayan pit vipers (Calloselasma rhodostoma) were responsible for 26 (84%) cases and green pit vipers (Trimeresurus species) for two cases (6%). In three patients (10%) the responsible snake could not be identified. Of these, two presented with signs of neurotoxicity and one with coagulopathy. A total of 124 vials of expired antivenom were administered. Fifty-nine vials had expired 2-18 months earlier, 56 vials 19-36 months and nine vials 37-60 months before. Adverse effects of variable severity were observed in seven (23%) patients. All 31 patients fully recovered from systemic envenoming. CONCLUSIONS: Under closely controlled conditions and monitoring the use of expired snake antivenom proved to be effective and safe. Discarding this precious medication is an unnecessary waste, and it could be a valuable resource in ameliorating the current shortage of antivenom. Emergency use authorization granted by health authorities and preclinical testing of expired antivenoms could provide the support and legal basis for such an approach.
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Antivenenos , Mordeduras de Serpentes , Humanos , Antivenenos/uso terapêutico , Mordeduras de Serpentes/tratamento farmacológico , LaosRESUMO
BACKGROUND: Thoracic Endovascular Aortic Repair (TEVAR) is a minimally invasive surgery for repairing thoracic aneurysms and dissections. This study aims to compare postoperative outcomes of TEVAR performed under general versus locoregional anesthesia. METHODS: Utilizing the 2008-2019 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database, patients older than the age of 18 years who received TEVAR, were identified using the following current procedural terminology codes: 33,880, 33,881, 33,883, 33,884, or 33,886. Patients who underwent concomitant procedures, those with both thoracoabdominal and abdominal aortic pathologies, and trauma cases were excluded. Standard descriptive statistics, in addition to χ2, Fisher's exact test, and Mann-Whitney U-tests were used to compare patient baseline characteristics and postoperative outcomes between general and locoregional anesthesia groups as appropriate. Univariable and multivariable logistic regression analyses were performed to assess independent predictors of hospital length of stay (LOS) greater than 7 days. RESULTS: Of the 1,028 patients included in the study, 86.5% received general anesthesia, and 13.5% received locoregional anesthesia, such as local anesthesia with monitored anesthesia care or regional anesthesia. No significant differences were found between patients receiving locoregional versus general anesthesia in mortality (3.6% vs. 7.9%, respectively, P = 0.071) and morbidity (18.7% and 24.8%, respectively, P = 0.121) within 30 days post-TEVAR, including any wound, pulmonary, thromboembolic, renal, septic, and cardiac arrest complications. Patients who received general anesthesia had significantly higher median LOS compared to those who received locoregional anesthesia [5 days (interquartile range (IQR): 3-10) versus 4 days (IQR: 2-7), P = 0.002], with 34.3% of the general anesthesia group having an LOS greater than 7 days compared to 21.6% of locoregional anesthesia group, P = 0.003. On multivariable logistic regression analysis, general anesthesia was found to be an independent predictor of prolonged LOS greater than 7 days (odds ratio (OR): 1.72, 95% confidence interval (CI): 1.05-2.81, P = 0.031). CONCLUSIONS: Locoregional anesthesia results in significantly lower postoperative hospital LOS with similar postoperative mortality and morbidity compared to general anesthesia in patients undergoing TEVAR.
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Anestesia por Condução , Aneurisma da Aorta Torácica , Implante de Prótese Vascular , Procedimentos Endovasculares , Humanos , Adolescente , Fatores de Risco , Procedimentos Endovasculares/efeitos adversos , Resultado do Tratamento , Fatores de Tempo , Aneurisma da Aorta Torácica/cirurgia , Anestesia por Condução/efeitos adversos , Implante de Prótese Vascular/efeitos adversos , Estudos Retrospectivos , Complicações Pós-Operatórias/etiologiaRESUMO
Wounds are considered to be a serious problem that affects the healthcare sector in many countries, primarily due to diabetes and obesity. Wounds become worse because of unhealthy lifestyles and habits. Wound healing is a complicated physiological process that is essential for restoring the epithelial barrier after an injury. Numerous studies have reported that flavonoids possess wound-healing properties due to their well-acclaimed anti-inflammatory, angiogenesis, re-epithelialization, and antioxidant effects. They have been shown to be able to act on the wound-healing process via expression of biomarkers respective to the pathways that mainly include Wnt/ß-catenin, Hippo, Transforming Growth Factor-beta (TGF-ß), Hedgehog, c-Jun N-Terminal Kinase (JNK), NF-E2-related factor 2/antioxidant responsive element (Nrf2/ARE), Nuclear Factor Kappa B (NF-κB), MAPK/ERK, Ras/Raf/MEK/ERK, phosphatidylinositol 3-kinase (PI3K)/Akt, Nitric oxide (NO) pathways, etc. Hence, we have compiled existing evidence on the manipulation of flavonoids towards achieving skin wound healing, together with current limitations and future perspectives in support of these polyphenolic compounds as safe wound-healing agents, in this review.
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Flavonoides , Fosfatidilinositol 3-Quinases , Cicatrização , Flavonoides/farmacologia , NF-kappa B/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Transdução de Sinais/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , HumanosRESUMO
Jellyfish stings are the most common cause of marine envenomation in humans. Various species of box jellyfish have been identified around Penang Island, Malaysia, and these include multitentacled and four-tentacled box jellyfish (class Cubozoa). The typical syndrome following envenomation from these jellyfish has been poorly documented, posing a greater challenge when managing an unidentified jellyfish sting from Penang Island. We report a case of a 32-y-old man from Penang Island who was stung by an unidentified jellyfish while walking into the sea. The patient reported that he felt an immediate and severe electric currentâlike pain over both thighs, left flank, and left forearm, followed by chest discomfort and breathlessness. Vinegar was applied over the affected areas, and he was rushed to a hospital, where he was treated with analgesia, steroids, and antihistamine. He refused hospitalization and was discharged against medical advice. He then presented to a noncoastal hospital 377 km away in Kuala Lumpur on the following day with severe pain over the affected sites as well as chest discomfort, shortness of breath, and abdominal cramps. The electrocardiograph demonstrated features of Wolff-Parkinson-White. Serial blood test results showed elevated creatine kinase but normal troponin I levels. The patient was managed symptomatically over a period of 4 d and was discharged with cardiology follow-up. Appropriate health-seeking behavior needs to be emphasized. This case report provides an opportunity to document the signs and symptoms of envenomation from possibly an undescribed jellyfish species near the coastal waters of Penang Island.
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Mordeduras e Picadas , Cnidários , Venenos de Cnidários , Cubomedusas , Cifozoários , Masculino , Animais , Humanos , Mordeduras e Picadas/complicações , Dor , Síndrome , HospitaisRESUMO
Neurogastroenterology and motility is a new but advanced subspecialty within gasteroenterology that cater to difficult, persistent and refractory gut-brain symptoms. Hospital USM has the country's first and new state-of-the art motility lab that was recently launched on the 25 May 2023, and is covered in nationwide media. Another first is the Brain-Gut Clinic, established on the 16 November 2022. The clinic is a new concept that builds on unique multiple disciplines in relation to the gut-brain axis. It is hoped that there will be more awareness on the existence of neurogastroenterology and motility among doctors and community, and that more research can be forthcoming to reduce the disease burden.
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This study aimed to determine the effect of synbiotic Musa acuminata skin extract (MASE) and Streptococcus salivarius K12 (K12) on Candida species biofilm formation. Liquid chromatography quadrupole time-of-flight (LC-Q-TOF-MS) was conducted to characterize MASE. To determine the effect of synbiotic on Candida biofilm, 200 µL of RPMI-1640 containing Candida, K12, and MASE were pipetted into the same well and incubated at 37 °C for 72 h. A similar protocol was repeated with K12 or MASE to determine the probiotic and prebiotic effects, respectively. Dimorphism, biofilm biomass, and Candida total cell count (TCC) were determined. A total of 60 compounds were detected in MASE. C. albicans (ALT5) and Candida lusitaniae exhibited the highest reduction in biofilm biomass when co-cultured with prebiotic (77.70 ± 7.67%) and synbiotic (97.73 ± 0.28%), respectively. All Candida spp. had decreased TCC and hyphae when co-cultured with synbiotic. In conclusion, MASE and K12 inhibit Candida biofilm formation.
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Musa , Streptococcus salivarius , Simbióticos , Biofilmes , Candida , Candida albicans , Extratos Vegetais/farmacologiaRESUMO
Consumption of pathogenic contaminated water has claimed the lives of many people. Hence, this scenario has emphasized the urgent need for research methods to avoid, treat and eliminate harmful pathogens in wastewater. Therefore, effective water treatment has become a matter of utmost importance. Membrane technology offers purer, cleaner, and pathogen-free water through the water separation method via a permeable membrane. Advanced membrane technology such as nanocomposite membrane, membrane distillation, membrane bioreactor, and photocatalytic membrane reactor can offer synergistic effects in removing pathogen through the integration of additional functionality and filtration in a single chamber. This paper also comprehensively discussed the application, challenges, and future perspective of the advanced membrane technology as a promising alternative in battling pathogenic microbial contaminants, which will also be beneficial and valuable in managing pandemics in the future as well as protecting human health and the environment. In addition, the potential of membrane technology in battling the ongoing global pandemic of coronavirus disease 2019 (COVID-19) was also discussed briefly.
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Effluent originating from cheese production puts pressure onto environment due to its high organic load. Therefore, the main objective of this work was to compare the influence of different process variables (transmembrane pressure (TMP), Reynolds number and feed pH) on whey protein recovery from synthetic and industrial cheese whey using polyethersulfone (PES 30 kDa) membrane in dead-end and cross-flow modes. Analysis on the fouling mechanistic model indicates that cake layer formation is dominant as compared to other pore blocking phenomena evaluated. Among the input variables, pH of whey protein solution has the biggest influence towards membrane flux and protein rejection performances. At pH 4, electrostatic attraction experienced by whey protein molecules prompted a decline in flux. Cross-flow filtration system exhibited a whey rejection value of 0.97 with an average flux of 69.40 L/m2h and at an experimental condition of 250 kPa and 8 for TMP and pH, respectively. The dynamic behavior of whey effluent flux was modeled using machine learning (ML) tool convolutional neural networks (CNN) and recursive one-step prediction scheme was utilized. Linear and non-linear correlation indicated that CNN model (R2 - 0.99) correlated well with the dynamic flux experimental data. PES 30 kDa membrane displayed a total protein rejection coefficient of 0.96 with 55% of water recovery for the industrial cheese whey effluent. Overall, these filtration studies revealed that this dynamic whey flux data studies using the CNN modeling also has a wider scope as it can be applied in sensor tuning to monitor flux online by means of enhancing whey recovery efficiency.
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Queijo , Soro do Leite , Queijo/análise , Filtração , Membranas Artificiais , Redes Neurais de Computação , Proteínas do Soro do LeiteRESUMO
Oilfield produced water (OPW) is one of the most important by-products, resulting from oil and gas exploration. The water contains a complex mixture of organic and inorganic compounds such as grease, dissolved salt, heavy metals as well as dissolved and dispersed oils, which can be toxic to the environment and public health. This article critically reviews the complex properties of OPW and various technologies for its treatment. They include the physico-chemical treatment process, biological treatment process, and physical treatment process. Their technological strengths and bottlenecks as well as strategies to mitigate their bottlenecks are elaborated. A particular focus is placed on membrane technologies. Finally, further research direction, challenges, and perspectives of treatment technologies for OPW are discussed. It is conclusively evident from 262 published studies (1965-2021) that no single treatment method is highly effective for OPW treatment as a stand-alone process however, conventional membrane-based technologies are frequently used for the treatment of OPW with the ultrafiltration (UF) process being the most used for oil rejection form OPW and oily waste water. After membrane treatment, treated effluents of the OPW could be reused for irrigation, habitant and wildlife watering, microalgae production, and livestock watering. Overall, this implies that target pollutants in the OPW samples could be removed efficiently for subsequent use, despite its complex properties. In general, it is however important to note that feed quality, desired quality of effluent, cost-effectiveness, simplicity of process are key determinants in choosing the most suitable treatment process for OPW treatment.
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Campos de Petróleo e Gás , Purificação da Água , Animais , Gado , Ultrafiltração , Águas Residuárias/análise , Purificação da Água/métodosRESUMO
Most researchers focused on developing highly selective membranes for CO2/CH4 separation, but their developed membranes often suffered from low permeance. In this present work, we aimed to develop an ultrahigh permeance membrane using a simple coating technique to overcome the trade-off between membrane permeance and selectivity. A commercial silicone membrane with superior permeance but low CO2/CH4 selectivity (in the range of 2-3) was selected as the host for surface modification. Our results revealed that out of the three silane agents tested, only tetraethyl orthosilicate (TEOS) improved the control membrane's permeance and selectivity. This can be due to its short structural chain and better compatibility with the silicone substrate. Further investigation revealed that higher CO2 permeance and selectivity could be attained by coating the membrane with two layers of TEOS. The surface integrity of the TEOS-coated membrane was further improved when an additional polyether block amide (Pebax) layer was established atop the TEOS layer. This additional layer sealed the pin holes of the TEOS layer and enhanced the resultant membrane's performance, achieving CO2/CH4 selectivity of ~19 at CO2 permeance of ~2.3 × 105 barrer. This performance placed our developed membrane to surpass the 2008 Robeson Upper Boundary.
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Amidas , Dióxido de Carbono , Humanos , Pesquisadores , Silanos , SiliconesRESUMO
Human population expansion into wildlife habitats has increased interest in the behavioural ecology of human-wildlife interactions. To date, however, the socioecological factors that determine whether, when or where wild animals take risks by interacting with humans and anthropogenic factors still remains unclear. We adopt a comparative approach to address this gap, using social network analysis (SNA). SNA, increasingly implemented to determine human impact on wildlife ecology, can be a powerful tool to understand how animal socioecology influences the spatiotemporal distribution of human-wildlife interactions. For 10 groups of rhesus, long-tailed and bonnet macaques (Macaca spp.) living in anthropogenically impacted environments in Asia, we collected data on human-macaque interactions, animal demographics, and macaque-macaque agonistic and affiliative social interactions. We constructed 'human co-interaction networks' based on associations between macaques that interacted with humans within the same time and spatial locations, and social networks based on macaque-macaque allogrooming behaviour, affiliative behaviours of short duration (agonistic support, lip-smacking, silent bare-teeth displays and non-sexual mounting) and proximity. Pre-network permutation tests revealed that, within all macaque groups, specific individuals jointly took risks by repeatedly, consistently co-interacting with humans within and across time and space. GLMMs revealed that macaques' tendencies to co-interact with humans was positively predicted by their tendencies to engage in short-duration affiliative interactions and tolerance of conspecifics, although the latter varied across species (bonnets>rhesus>long-tailed). Male macaques were more likely to co-interact with humans than females. Neither macaques' grooming relationships nor their dominance ranks predicted their tendencies to co-interact with humans. Our findings suggest that, in challenging anthropogenic environments, less (compared to more) time-consuming forms of affiliation, and additionally greater social tolerance in less ecologically flexible species with a shorter history of exposure to humans, may be key to animals' joint propensities to take risks to gain access to resources. For males, greater exploratory tendencies and less energetically demanding long-term life-history strategies (compared to females) may also influence such joint risk-taking. From conservation and public health perspectives, wildlife connectedness within such co-interaction networks may inform interventions to mitigate zoonosis, and move human-wildlife interactions from conflict towards coexistence.
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Animais Selvagens , Efeitos Antropogênicos , Animais , Feminino , Asseio Animal , Humanos , Masculino , Comportamento Social , Análise de Rede SocialRESUMO
BACKGROUND: Available data on influenza burden across Southeast Asia are largely limited to pediatric populations, with inconsistent findings. METHODS: We conducted a multicenter, hospital-based active surveillance study of adults in Malaysia with community-acquired pneumonia (CAP), acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and acute exacerbation of asthma (AEBA), who had influenza-like illness ≤10 days before hospitalization. We estimated the rate of laboratory-confirmed influenza and associated complications over 13 months (July 2018-August 2019) and described the distribution of causative influenza strains. We evaluated predictors of laboratory-confirmed influenza and severe clinical outcomes using multivariate analysis. RESULTS: Of 1106 included patients, 114 (10.3%) were influenza-positive; most were influenza A (85.1%), with A/H1N1pdm09 being the predominant circulating strain during the study following a shift from A/H3N2 from January-February 2019 onwards. In multivariate analyses, an absence of comorbidities (none versus any comorbidity [OR (95%CI), 0.565 (0.329-0.970)], p = 0.038) and of dyspnea (0.544 (0.341-0.868)], p = 0.011) were associated with increased risk of influenza positivity. Overall, 184/1106 (16.6%) patients were admitted to intensive care or high-dependency units (ICU/HDU) (13.2% were influenza positive) and 26/1106 (2.4%) died (2.6% were influenza positive). Males were more likely to have a severe outcome (ICU/HDU admission or death). CONCLUSIONS: Influenza was a significant contributor to hospitalizations associated with CAP, AECOPD and AEBA. However, it was not associated with ICU/HDU admission in this population. Study registration, NMRR ID: NMRR-17-889-35,174.
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Asma/complicações , Infecções Comunitárias Adquiridas/complicações , Vírus da Influenza A Subtipo H3N2 , Influenza Humana/complicações , Pneumonia/complicações , Doença Pulmonar Obstrutiva Crônica/complicações , Adulto , Idoso , Pré-Escolar , Hospitalização , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The high mortality rates seen within the first postoperative year after hip fracture surgery have remained relatively unchanged in many countries for the past 15 years. Recent investigations have shown an association between beta-blocker (BB) therapy and a reduction in risk-adjusted mortality within the first 90 days after hip fracture surgery. We hypothesized that preoperative, and continuous postoperative, BB therapy may also be associated with a decrease in mortality within the first year after hip fracture surgery. METHODS: In this retrospective cohort study, all adults who underwent primary emergency hip fracture surgery in Sweden, between January 1, 2008 and December 31, 2017, were included. Patients with pathological fractures and conservatively managed hip fractures were excluded. Patients who filled a prescription within the year before and after surgery were defined as having ongoing BB therapy. The primary outcome of interest was postoperative mortality within the first year. To reduce the effects of confounding from covariates due to nonrandomization in the current study, the inverse probability of treatment weighting (IPTW) method was used. Subsequently, Cox proportional hazards models were fitted to the weighted cohorts. These analyses were repeated while excluding patients who died within the first 30 days postoperatively. This reduces the effect of early deaths due to surgical and anesthesiologic complications as well as the higher degree of advanced directives present in the study population compared to the general population, which allowed for the evaluation of the long-term association between BB therapy and mortality in isolation. Results are reported as hazard ratios (HR) with 95% confidence intervals (CI). Statistical significance was defined as a 2-sided P value <.05. RESULTS: A total of 134,915 cases were included in the study. After IPTW, BB therapy was associated with a 42% reduction the risk of mortality within the first postoperative year (adjusted HR = 0.58, 95% CI, 0.57-0.60; P < .001). After excluding patients who died within the first 30 days postoperatively, BB therapy was associated with a 27% reduction in the risk of mortality (adjusted HR = 0.73, 95% CI, 0.71-0.75; P < .001). CONCLUSIONS: A significant reduction in the risk of mortality in the first year following hip fracture surgery was observed in patients with ongoing BB therapy. Further investigations into this finding are warranted.
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Antagonistas Adrenérgicos beta/uso terapêutico , Fixação de Fratura , Fraturas Espontâneas/cirurgia , Fraturas do Quadril/cirurgia , Antagonistas Adrenérgicos beta/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Feminino , Fixação de Fratura/efeitos adversos , Fixação de Fratura/mortalidade , Fraturas Espontâneas/mortalidade , Fraturas do Quadril/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Suécia , Fatores de Tempo , Resultado do TratamentoRESUMO
Monitoring the COVID-19 virus through patients' saliva is a favorable non-invasive specimen for diagnosis and infection control. In this study, salivary samples of COVID-19 patients collected from 6 patients with the median age of 58.5 years, ranging from 34 to 72 years (2 females and 4 males) were analyzed using an Au/fiber Bragg grating (FBG) probe decorated with GO. The probe measures the prevalence of positivity in saliva and the association between the virus density and changes to sensing elements. When the probe is immersed in patients' saliva, deviation of the detected light wavelength and intensity from healthy saliva indicate the presence of the virus and confirms infection. For a patient in the hyperinflammatory phase of desease, who has virus density of 1.2 × 108 copies/mL in saliva, the maximum wavelength shift and intensity changes after 1600 s were shown to be 1.12 nm and 2.01 dB, respectively. While for a patient in the early infection phase with 1.6 × 103 copies/mL, these values were 0.98 nm and 1.32 dB. The precise and highly sensitive FBG probe proposed in this study was found a reliable tool for quick detection of the COVID-19 virus within 10 s after exposure to patients' saliva in any stage of the disease.
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The vast amount of oily wastewater released to the environment through industrialization has worsened the water quality in recent years, posing adverse impacts on general human health. Oil emulsified in water is one of the most difficult mixtures to be treated, making it imperative for new technology to be explored to address this issue. The use of conventional water treatment such as flotation, coagulation, precipitation, adsorption, and chemical treatment have low separation efficiencies and high energy costs, and are not applicable to the separation of oil/water emulsions. Therefore, there is a demand for more efficient methods and materials for the separations of immiscible oil/water mixtures and emulsions. Superwetting materials that can repel oil, while letting water pass through have been widely explored to fit into this concern. These materials usually make use of simultaneous hydrophilic/oleophobic mechanisms to allow a solid surface to separate oily emulsion with little to no use of energy. Also, by integrating specific wettability concepts with appropriate pore scale, solid surfaces may achieve separation of multifarious oil/water mixtures namely immiscible oil/water blends and consolidated emulsions. In this review, materials used to impart superwetting in solid surfaces by focusing on superhydrophilic/superoleophobic wetting properties of the materials categorized into fluorinated and non-fluorinated surface modification are summarized. In each material, its background, mechanism, fabricating processes, and their effects on solid surface's wetting capability are elaborated in detail. The materials reviewed in this paper are mainly organic and green, suggesting the alternative material to replace the fluorine group that is widely used to achieve oleophobicity in oily wastewater treatment.
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Óleos , Purificação da Água , Humanos , Interações Hidrofóbicas e Hidrofílicas , Águas Residuárias , MolhabilidadeRESUMO
Polymer blends is a well-established and suitable method to produced new polymeric materials as compared to synthesis of a new polymer. The combination of two different types of polymers will produce a new and unique material, which has the attribute of both polymers. The aim of this work is to analyze mechanical and morphological properties of bio-phenolic/epoxy polymer blends to find the best formulation for future study. Bio-phenolic/epoxy polymer blends were fabricated using the hand lay-up method at different loading of bio-phenolic (5 wt%, 10 wt%, 15 wt%, 20 wt%, and 25 wt%) in the epoxy matrix whereas neat bio-phenolic and epoxy samples were also fabricated for comparison. Results indicated that mechanical properties were improved for bio-phenolic/epoxy polymer blends compared to neat epoxy and phenolic. In addition, there is no sign of phase separation in polymer blends. The highest tensile, flexural, and impact strength was shown by P-20(biophenolic-20 wt% and Epoxy-80 wt%) whereas P-25 (biophenolic-25 wt% and Epoxy-75 wt%) has the highest tensile and flexural modulus. Based on the finding, it is concluded that P-20 shows better overall mechanical properties among the polymer blends. Based on this finding, the bio-phenolic/epoxy blend with 20 wt% will be used for further study on flax-reinforced bio-phenolic/epoxy polymer blends.
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Resinas Epóxi/química , Teste de Materiais , Estresse Mecânico , Resistência à TraçãoRESUMO
OBJECTIVES: Dysglycemia is known to be a common comorbidity of chronic obstructive pulmonary disease (COPD). However, undiagnosed dysglycemia and the associated factors remain under-reported. This study aimed to determine the prevalence and the associated factors of dysglycemia among COPD patients. METHODS: This was a cross-sectional, single-center study involving adults with established COPD (n = 186) divided into those with or without hospital admissions for acute exacerbation. Oral glucose tolerance test (OGTT) was performed in patients with no known history of dysglycemia. RESULTS: There were 16 patients who had overt diabetes, and 32 had prediabetes following the OGTT. Forty percent had histories of hospital admissions for COPD exacerbations. Both groups demonstrated similar 2-h post prandial glucose, glycated hemoglobin (HbA1c) and fasting blood glucose. The incidences of newly diagnosed dysglycemia were higher in both groups (40.8% vs 34.6%, p = 0.57). Cumulative days of admission (≥6 days/year) and weight (≥65 kg) were identified as predictors for dysglycemia within the study population. DISCUSSION: This study demonstrated a high number of overt and newly diagnosed dysglycemia among COPD patients who had no previous history of abnormal glucose. Recent acute exacerbations of COPD could have a negative impact on glycemia, although the results did not attain statistical significance. However, there is a need for adequate screening for dysglycemia, particularly among those with frequent acute exacerbations of their condition.