Monolignol Potential and Insights into Direct Depolymerization of Fruit and Nutshell Remains for High Value Sustainable Aromatics

The inedible parts of nuts and stone fruits are low-cost and lignin-rich feedstock for more sustainable production of aromatic chemicals in comparison with the agricultural and forestry residues. However, the depolymerization performances on food-related biomass remains unclear, owing to the broad physicochemical variations from the edible parts of the fruits and plant species. In this study, the monomer production potentials of ten major fruit and nutshell biomass were investigated with comprehensive numerical information derived from instrumental analysis, such as plant cell wall chemical compositions, syringyl/guaiacyl (S/G ratios, and contents of lignin substructure linkages (β-O-4, β-β, β-5). A standardized one-pot reductive catalytic fractionation (RCF) process was applied to benchmark the monomer yields, and the results were statistically analyzed. Among all the tested biomass, mango endocarp provided the highest monolignol yields of 37.1 % per dry substrates. Positive S-lignin (70-84 %) resulted in higher monomer yield mainly due to more cleavable β-O-4 linkages and less condensed C-C linkages. Strong positive relationships were identified between β-O-4 and S-lignin and between β-5 and G-lignin. The analytical, numerical, and experimental results of this study shed lights to process design of lignin-first biorefinery in food-processing industries and waste management works.

Sequential mediation analysis of physical activity, healthy diet, BMI, and academic burnout in the Pakistani educational landscape

Research has indicated a negative impact of physical activity on academic burnout among students, however, there is a paucity of evidence about the underlying mechanism of this association in Pakistani students. The present research seeks to investigate the relationship between physical activity and academic burnout by investigating the potential mediating effects of adherence to the Mediterranean diet (MD) and body mass index (BMI). A sample of 596 students using a cross-sectional survey design was gathered from two public universities (Riphah International University and Mohammed Ali Jinnah University) in Rawalpindi, Pakistan from June to July 2022. The study participants were asked to fill out the Physical Activity Rating Scale-3, the Learning Burnout Scale, and the Test of Adherence to MD questionnaires. The study employed descriptive, bivariate, and path analysis through regression utilizing the SPSS software version 27. The findings demonstrated a negative correlation between academic burnout and BMI, physical activity, and adherence to the MD. The relationship between physical activity and academic burnout was mediated by BMI. Physical activity and academic burnout were inversely correlated, with adherence to the MD and BMI interacting as sequential mediators. The outcomes of this research have expanded our knowledge of the association between physical activity and academic burnout and have suggested crucial and appropriate strategies for addressing student academic burnout.

Psychological dynamics of pandemic resilience: a tale of two cultures

The present work endeavours to explore the experiences of university-level students from Pakistan and Nepal after the COVID-19 outbreak. A comprehensive electronic survey was carried out utilising a meticulous cluster sampling technique encompassing two distinct populations, i.e. Pakistan and Nepal, during the period extending from September 2022 to January 2023. A total of 2496 participants completed the questionnaire (Pakistani population: 55.45% and Nepalese population: 44.55%). We utilised the Mental Health Continuum-Short Form (MHC-SF), Pittsburgh Sleep Quality Index (PSQI), feeling of loneliness (UCLA), interdependent happy scale (IHS), and fear of COVID-19 scale (FCV-19S). Notably, a significant intercultural disparity was observed, particularly concerning the level of COVID-19 fear which was higher among the Nepalese population. However, this particular variable did not demonstrate any significant associations with other variables, except for the social dimension of MHC-SF. There was a negative correlation observed between this variable and IHS within the Pakistani population. Irrespective of the varying degrees of apprehension towards COVID-19 within the two distinct cultural contexts, there exists a significant positive correlation between the assessed psychological assets and individual well-being, as well as the resumption of regular activities after the outbreak.

Potential determinants of parental hesitancy to vaccinate their children against COVID-19 infection: a cross-sectional investigation

Coronavirus disease 2019 (COVID-19) vaccination hesitancy has emerged as a substantial concern among the adult population globally. However, limited evidence is available about parental hesitancy to vaccinate their children against COVID-19 within the Pakistani context. Thus, the present investigation aimed to assess parental attitudes, perceptions, and willingness regarding vaccination hesitancy and associated predictors of getting their children vaccinated against COVID-19. We conducted a cross-sectional population-based, self-administered online questionnaire in Punjab, Pakistan, on randomly selected parents between October 2022 and February 2023. The data were collected based on socio-demographics, attitudes, perceptions, and willingness of parents regarding COVID-19 vaccine hesitancy for their children. Adjusted odds ratios with 95% confidence intervals were estimated to identify the predictors of vaccine hesitancy. The findings demonstrated that among 1,478 participants, a total of 40% believed that the COVID-19 vaccine may pose a greater risk to children than adults, while 38% exhibited no concerns. Around 13% of children were not vaccinated in our study sample. More than half expressed hesitancy toward vaccination, and only 35.25% were inclined to get their children vaccinated in our study sample. In addition, only 16% of the parents believed that the COVID-19 vaccination may cause an alteration in their children's DNA. A similar proportion of parents were aware of the significance of getting their children vaccinated and expressed their willingness to vaccinate their children to prevent the COVID-19 infection. However, a higher odds ratio was observed in females with a higher educational background and those in the healthcare profession. In conclusion, healthcare awareness-supporting programs for educating parents should be designed and implemented. These insights might aid in the development of strategies to eradicate barriers in existing coronavirus vaccination programs and may vaccinate a larger child population to reduce the adverse consequences of the pandemic.

Substrate-related factors and kinetic studies of Carbohydrate-Rich food wastes on enzymatic saccharification

Food waste biorefinery is a sustainable approach to producing green chemicals, however the essential substrate-related factors hindering the efficacy of enzymatic hydrolysis have never been clarified. This study explored the key rate-limiting parameters and mechanisms of carbohydrate-rich food after different cooking and storing methods, i.e., impacts of compositions, structural diversities, and hornification. Shake-flask enzymatic kinetics determined the optimal dosages (0.5 wt% glucoamylase, 3 wt% cellulase) for food waste hydrolysis. First order kinetics and simulation results determined that reaction coefficient (K) of cooked starchy food was ∼ 3.63 h-1 (92 % amylum digestibility) within 2 h, while those for cooked cellulosic vegetables were 0.25-0.5 h-1 after 12 h of hydrolysis. Drying and frying reduced ∼ 71-89 % hydrolysis rates for rice, while hydrothermal pretreatment increased the hydrolysis rate by 82 % on vegetable wastes. This study provided insights into advanced control strategy and reduced the operational costs by optimized enzyme doses for food waste valorization.

Potential Correlation Between Self-Compassion and Bedtime Procrastination: The Mediating Role of Emotion Regulation

Purpose

The present research aims to investigate the potential correlations between self-compassion and bedtime procrastination, a significant behavior related to sleep. In this research, we put forward the hypothesis that a reduction in negative affect and the implementation of adaptative emotion regulation strategies can elucidate the established connections between self-compassion and a decreased tendency for bedtime procrastination.

Methods

Two cross-sectional online surveys (Survey I: n=241 and Survey II: n=546) were carried out via a convenient sampling method. Prior to their inclusion, all participants underwent a thorough assessment to confirm no evidence of clinical insomnia. The study participants in both survey investigations were asked to complete various psychometric assessments, including self-compassion, positive and negative affect, and bedtime procrastination; however, the study participants in Survey II additionally underwent the administration of a cognitive reappraisal assessment.

Results

In Survey I, a multiple mediation analysis was conducted to examine the mediating effects of self-compassion on reducing bedtime procrastination through a reduction in negative affect. The results supported the hypothesized relationships, indicating that self-compassion had the expected mediated effects by mitigating negative affective states. However, contrary to expectations, higher positive affect did not mediate the relationship between self-compassion and reduced bedtime procrastination. The findings of Survey II were confirmed through the utilization of path analysis. Moreover, this analysis provided additional evidence to suggest that the mechanism of cognitive reappraisal could account for the observed decrease in negative affect associated with self-compassion. The present study found a notable and sustained impact of self-compassion on reducing instances of delaying bedtime activities.

Conclusion

The present research contributes novel empirical evidence suggesting a negative association between self-compassion and the propensity to engage in bedtime procrastination. This relationship can be attributed partly to the implementation of an adaptative emotion regulation mechanism that effectively alleviates negative affect.

An overview of floral regulatory genes in annual and perennial plants

The floral initiation in angiosperms is a complex process influenced by endogenous and exogenous signals. With this approach, we aim to provide a comprehensive review to integrate this complex floral regulatory process and summarize the regulatory genes and their functions in annuals and perennials. Seven primary paths leading to flowering have been discovered in Arabidopsis under several growth condition that include; photoperiod, ambient temperature, vernalization, gibberellins, autonomous, aging and carbohydrates. These pathways involve a series of interlinked signaling pathways that respond to both internal and external signals, such as light, temperature, hormones, and developmental cues, to coordinate the expression of genes that are involved in flower development. Among them, the photoperiodic pathway was the most important and conserved as some of the fundamental loci and mechanisms are shared even by closely related plant species. The activation of floral regulatory genes such as FLC, FT, LFY, and SOC1 that determine floral meristem identity and the transition to the flowering stage result from the merging of these pathways. Recent studies confirmed that alternative splicing, antisense RNA and epigenetic modification play crucial roles by regulating the expression of genes related to blooming. In this review, we documented recent progress in the floral transition time in annuals and perennials, with emphasis on the specific regulatory mechanisms along with the application of various molecular approaches including overexpression studies, RNA interference and Virus-induced flowering. Furthermore, the similarities and differences between annual and perennial flowering will aid significant contributions to the field by elucidating the mechanisms of perennial plant development and floral initiation regulation.

Reverse osmosis membrane functionalized with aminated graphene oxide and polydopamine nanospheres plugging for enhanced NDMA rejection and anti-fouling performance

The use of reverse osmosis (RO) for water reclamation has become an essential part of the water supply owing to the ever-increasing water demand and the utmost performance of the RO membranes. Despite the global RO implementation, its inferior rejection against low molecular weight contaminants of emerging concerns (CECs) (i.e., N-nitrosodimethylamine (NDMA)) and propensity to fouling remain bottle-neck thus affecting process robustness for water reuse. This study aims to enhance both the rejection and antifouling properties of the RO membrane. Herein for the first time, we report RO membrane modification using polydopamine nanospheres (PDAns) followed by aminated-graphene oxide (AGO) deposition as an effective approach to overcome these challenges. The modification of the RO membrane using PDAns-AGO resulted in 89.3 ± 2.7% rejection compared to the pristine RO membrane which demonstrated 69.2 ± 2.1% NDMA rejection. This significant improvement can be ascribed to the plugging and shielding of defective areas (formed during interfacial polymerization) of the polyamide layer through active PDAns and AGO layers and to the added sieving mechanism that arose through narrow channels of the AGO owing to its reduction. Moreover, the in-situ and non-destructive fouling monitoring using optical coherence tomography (OCT) revealed that the PDAns-AGO coating enhanced both the anti-scaling and anti-biofouling characteristics. The improved hydrophilicity and bactericidal effect together with roughness and surface charge suppression synergistically enhanced anti-fouling properties. This study provides a new direction for safe and cost-effective water reuse practices. The membrane with high selectivity against CECs such as NDMA has the potential to eliminate permeate staging using second pass RO and other advanced oxidation processes which are utilized as a tertiary treatment to make reclaimed water suitable for potable/non-potable application.

Potential determinants of vaccine hesitancy among celiac disease patients: a single cohort analysis

Introduction

Though researchers and scholars have greatly emphasized addressing the influencing factors of vaccination hesitancy, little attention has been paid to patients with celiac disease. Addressing the variables hampering attitudes might help direct appropriate patient advocacy and doctor-patient communication endeavors to encourage vaccination among celiac disease patients. The present investigation seeks to explore the coverage against vaccine-preventable diseases, vaccination attitudes, and related possible factors among celiac disease patients in the Pakistani setting.

Methods

A self-reported online survey was conducted in Islamabad, Pakistan, for celiac disease patients aged 18 and above. The questionnaire was completed by 226 participants, with a response rate of 43.8%. The influencing variables for vaccination hesitancy were examined, and 95% confidence intervals for the crude and adjusted odds ratios were computed.

Results

Among the study population, the majority were females, with a ratio of 75.66%. A prominent proportion of 69.03% was observed for influenza vaccination, while 39.82% were unable to recall all of the vaccinations they had previously received. Only 7% of the patients were considered to have a negative attitude toward vaccination, compared to an estimated 76% who were in favor of it. The significantly positive influencing factors observed toward vaccination were being well-educated (graduate, master, or above), possible recurrence of vaccine-preventable diseases with declining vaccination coverage (adjusted OR: 13.36), and increased confidence in vaccines from health care experts compared to electronic media (adjusted OR: 8.41). Contrarily, practicing complementary and alternative medicines (adjusted OR: 5.59), willingness to get vaccinated again in the future (adjusted OR: 15.59), and prior negative perspectives (adjusted OR: 1.01) were the determinants with a significant negative association.

Discussion

In conclusion, the outcomes of the current work raise the possibility that health practitioners may be accountable for inappropriately prescribing vaccines to this demographic since 77% of the participants had a favorable attitude toward vaccination. These findings could serve as a springboard for creating targeted immunization efforts to raise vaccination coverage against vaccine-preventive diseases among celiac disease patients.

Inflammatory biomarkers and cardiac injury in COVID-19 patients

Introduction

Cardiac injury has received considerable attention due to the higher risk of morbidity and mortality associated with coronavirus disease. However, in a developing country, there is a scarcity of data on cardiac injury in COVID-19 patients related to inflammatory biomarkers.

Methods

Therefore, the present research retrospectively analyzes data from three territorial hospitals in Pakistan's Punjab province to investigate the potential impact of the cardiac injury on the mortality and severity of COVID-19-infected patients. We evaluated 2,051 patients between January 16 and April 18, 2022, with confirmed COVID-19. The in-hospital mortality recorded for the selected sample size was about 16.28%.

Results

The majority of the participants were identified as male (64%) with a median age of 65 years. Also, fever, fatigue, and dyspnea were reported as common symptoms. An aggregate of 623 patients (30.38%) had a cardiac injury, and when these patients are compared to those without cardiac injury, the participants were significantly older and had more comorbidities with higher leukocyte counts, elevated levels of C-reactive protein, interleukin-6, procalcitonin, myohemoglobin, creatinine kinase-myocardial band, serum creatinine, high-sensitivity troponin-I, N-terminal pro-B-type natriuretic peptide had a significant amount of multiple ground-glass opacity and bilateral pulmonary infiltration in radiographic results. Participants with heart injury required more non-invasive or invasive mechanical respiration than those who did not have a cardiac injury. Individuals with cardiac injury had higher rates of sepsis, acute respiratory distress syndrome (ARDS), d-dimer concentration, and respiratory failure than those without cardiac injury. Patients who had had a cardiac injury died at a higher rate than those who had not suffered cardiac damage. In the multivariable logistic regression analysis, participants with cardiac injury showed greater odds of COVID-19 mortality and were found associated with older age (OR = 1.99, 95% CI = 0.04-3.19), elevated cardiac troponin I (OR = 18.64, 95% CI = 13.16-23.01), the complication of sepsis (OR = 10.39, 95% CI = 7.41-13.39) and ARDS (OR = 6.65, 95% CI = 4.04-8.91).

Conclusion

Cardiac injury is a frequent complication among patients with coronavirus-induced infection in Punjab, Pakistan, and it is significantly linked to a greater risk of in-hospital mortality.

Biomass pyrolysis: A review on recent advancements and green hydrogen production

Biomass pyrolysis has recently gained increasing attention as a thermochemical conversion process for obtaining value-added products, thanks to the development of cutting-edge, innovative and cost-effective pyrolysis processes. Over time, new and novel pyrolysis techniques have emerged, and these processes can be tuned to maximize the production of high-quality hydrogen. This review examines recent advancements in biomass pyrolysis by classifying them into conventional, advanced and emerging approaches. A comprehensive overview on the recent advancements in biomass pyrolysis, highlighting the current status for industrial applications is presented. Further, the impact of each technique under different approaches on conversion of biomass for hydrogen production is evaluated. Techniques, such as inline catalytic pyrolysis, microwave pyrolysis, etc., can be employed for the sustainable production of hydrogen. Finally, the techno-economic analysis is presented to understand the viability of pyrolysis at large scale. The outlook highlights discernments into future directions, aimed to overcome the current shortcomings.

Particulate air pollution and metabolic risk factors: Which are more prone to cardiac mortality

This study explored multiplex, country-level connections between a wide range of cardiac risk factors and associated mortality within the South Asian Association for Regional Cooperation (SAARC) countries. The grey relational analysis (GRA) methodology is used to evaluate data from 2001 to 2018 to compute scores and rank countries based on cardiac mortality. Subsequently, we used the conservative (Min-Max) technique to determine which South Asian country contributes the most to cardiac mortality. The Hurwicz criterion is further applied for optimization by highlighting the risk factors with the highest impact on cardiac mortality. Empirical findings revealed that India and Nepal are the leading drivers of cardiovascular disease (CVD) mortality among all SAARC nations based on the results of the GRA methodology. Moreover, the outcomes based on the Hurwicz criterion and the conservative criterion indicated that CVD mortality is considerably impacted by household air pollution from the combustion of solid fuel, with India as a potential contributor in the SAARC region. The outcomes of this research may enable international organizations and public health policymakers to make better decisions and investments within the SAARC region to minimize the burden of CVD while also strengthening environmentally sustainable healthcare practices.

Micronutrient deficiencies and cardiac health

Inadequate diet and nutritional quality are potentially correlated with an escalated risk of cardiac-related morbidity and mortality. A plethora of knowledge is available regarding the influence of heart-healthy dietary patterns in response to disability-adjusted life years (DALYs), yet little is known regarding the best approaches to adopt. In response, the present investigation aims to bridge this knowledge gap by implementing mathematical machine learning grey methodology to assess the degree of influence and the potential contributing factors in DALYs due to ischemic heart disease and stroke, in conjunction with the Hurwicz (Min-Max) criterion. The outcomes highlighted that a diet low in fruits is a potential contributor to IHD-related DALYS, whereas a diet low in vegetables is a more grounded contributor to stroke-related DALYs in Spain, among others. Moreover, the Hurwicz approach highlighted IHD to be more impacted due to dietary and nutritional factors than stroke. In conclusion, our investigation strongly supports a balanced diet and precision nutrition guidelines as a strategy for reducing cardiac-related diseases in the Spanish population. It is a public health primary consideration to build an ambiance that encourages, rather than hinders, compliance with cardioprotective dietary practices among all people.

Does the intubation timeline affect the in-hospital mortality of COVID-19 patients? A retrospective cohort study

Background

Effective strategies for managing coronavirus disease 19 (COVID-19) patients suffering from acute respiratory distress are constantly evolving. The timeline and threshold for transitioning from non-invasive ventilation to intermittent mandatory ventilation in critical cases who develop COVID-19-related respiratory distress are undetermined. The present research intends to investigate if emergency room intubations in COVID-19 patients affect mortality.

Methods

Between January 1, 2021 and June 30, 2021, we retrospectively reviewed chart analysis on all patients with confirmed positive COVID-19 screening and who underwent endotracheal intubation. Depending on when the intubation was performed; early in the emergency room or delayed outside the emergency room, patients were separated into two cohorts. In addition to comorbid clinical manifestations, the quick sequential organ failure assessment (qSOFA) score, and in-hospital mortality were all recorded as demographic and clinical information.

Results

Fifty-eight of the 224 corona-positive patients who underwent intubation had their intubations performed in the emergency room. Age, sex, alcohol use, and smoking status did not significantly differ between the two categories at the baseline. The mean qSOFA score was higher in the early intubation cohort (3.5; p < 0.000) along with more underlying comorbidities (3.0; p < 0.000). When compared to the late intubation cohort (45.78%), patients treated with early intubation had a significantly greater death rate (67.24%).

Conclusion

In summary, we discovered that patients who underwent intubation in the emergency units exhibited a high quick SOFA score as well as maximum co-morbid conditions than patients intubated somewhere else in the hospital. The findings of our investigation imply that intubating patients too early might be risky.

Uptake of COVID-19 booster shot among healthcare workers: A mediation analysis approach

Since the thrust of previous research investigations has been on people's willingness to get immunized against the COVID-19 infection, the underpinning principle of compliance has received very little attention. Addressing the possible drivers and mechanisms influencing vaccine acceptance may provide significant insights for limiting the pandemic. In response, we intend to investigate the influence of decision regret and the consequences of post-vaccination adverse effects on the inclination to undertake booster shots. An electronic survey that was self-administered was conducted in Rawalpindi, Pakistan. The questionnaire was completed by 1,369 participants, with a response rate of 41%. 1,343 of them (98.10%) had received both doses of the COVID-19 vaccination. Besides, the present research has also adopted a mediation model. Our findings demonstrate that unfavorable vaccination responses in healthcare workers significantly affect their likelihood of receiving booster shots. Interestingly, healthcare workers who had adverse experiences after being immunized were more prone to regret their prior immunization decisions, which in response affected their decision to get a booster shot. The motivation to receive the booster dosage and adverse post-vaccination responses were mediated by decision regret. The outcomes suggested indissociable connections between unfavorable vaccination responses, decision regret, and the likelihood of receiving a booster shot. To strengthen immunization acceptance intent and enhance the likelihood of receiving COVID-19 booster shots, it is recommended that awareness of these post-vaccination adverse events be extensively integrated into immunization awareness programs and policy measures supporting booster doses.

364 Systematic Review of Simulation-Based Training Tools in Plastic Surgery

Aim

The recent shift from traditional surgical teaching to the incorporation of simulation training in plastic surgery has resulted in the development of a variety of simulation models and tools. We aim to identify all currently available simulators and tools for plastic surgery, assess their validity and establish their effectiveness.

Method

MEDLINE and Embase were searched for articles which validate simulation models in plastic surgery. Each study was screened in accordance with the Messick validity framework, and a rating was given for each section. In order to determine the effectiveness of each study, the McGaghie model of translational outcomes was used.

Results

On screening 2104 articles, 71 were identified to discuss validity and effectiveness. Only one study was found to achieve a high score in all validity parameters and no studies achieved an effectiveness level &gt;2.

Conclusions

With the increasing amount of simulation training tools, there must be more validity studies conducted using updated validity frameworks. In addition, there should be an increased emphasis of the relationship between these simulators and patient outcomes/surgical technique in the operating theatre in order to determine translational outcomes. More training tools evaluating both technical and nontechnical surgical skills are recommended.

Cardiovascular Disease Mortality and Potential Risk Factor in China: A Multi-Dimensional Assessment by a Grey Relational Approach

Objectives: This study aims to investigate the impact of hypertension, diabetes, and high blood cholesterol on increased mortality from cardiovascular diseases such as coronary heart disease, stroke, and pulmonary heart disease in a multi-dimensional way. Methods: The grey relational analysis methodology is adopted to assess the connection between cardiac risk factors and related mortality. The Hurwicz and the Conservative (Min-Max) criterion approach are also utilized to identify the prospective risk factor that contributes the most to increased cardiac mortality. Results: The findings reveal that hypertension has a more grounded relationship with stroke and pulmonary heart disease mortality, whereas high blood cholesterol appears to be the leading contributor to deaths from coronary heart disease. The results based on the Hurwicz and the Min-Max criterion show a robust connection between dyslipidemia, coronary heart disease, and cardiovascular disease mortality. Conclusion: Combating uncontrolled blood cholesterol and blood pressure levels would necessitate a multi-pronged strategy at both the national and local levels. Besides, the suggested methodologies provide a valuable tool and additional practical knowledge for public health policymakers and decision-makers in drawing rational decisions to combat China's rising CVD burden.

Pyrolysis of anaerobic digested residues in the presence of catalyst-sorbent bifunctional material: Pyrolysis characteristics, kinetics and evolved gas analysis

We investigated the potential application of anaerobically digested residues for generating bioenergy in the presence of alkali bifunctional material, sodium zirconate (Na₂ZrO₃, NZ) using a thermogravimetric analyzer connected to a mass spectrometer. Isoconversional kinetic models, compensation effect and master-plots method were used on data obtained under multiple heating rates (10, 15 and 20 °C min^-1) to calculate the activation energy (E_α) and pre-exponential value (A) and reaction mechanism. The average E_α for blend samples C-DSW (NZ mixed with digested municipal solid waste (DSW)), and C-DSM (NZ mixed with digested swine manure (DSM)) were 172.24 and 171.63 kJ mol^-1, which were much lower when compared to plain samples, DSW (202.51 kJ mol^-1) and DSM (215.22 kJ mol^-1). The total gas yields increased by 19.5 and 17.1% for NZ blended samples C-DSW and C-DSM, respectively. In addition, the hydrogen yields also increased by 79 and 44% for C-DSW and C-DSM, respectively.

Bioconversion of food and lignocellulosic wastes employing sugar platform: A review of enzymatic hydrolysis and kinetics

Bioenergy and biochemicals can be sustainably produced through fermentation and anaerobic digestion (AD). However, this bioconversion processes could be more economical if the hydrolysis rates of substrates in bioreactors can be accelerated. In this review, the feasibilities of including enzymatic hydrolysis (EH) in various bioconversion systems were studied to facilitate the biological synergy. The reaction kinetics of EH in bioconversion systems comparing pretreated lignocellulosic biomass (LCB) and food waste (FW) substrates were reviewed. Possible strategies to improve the hydrolysis efficiency were explored, including co-cultivation during enzyme production and replacement of pure enzyme with on-site produced fungal mash during EH. Key insights into improvement of current AD and fermentation technologies were summarized and further formed into suggestions of future directions in techno-economic feasibility of biorefinery using mixture of the first-generation food crop feedstock with FW; and/or co-digestion of FW with LCB.

Long-Term Air Pollution Exposure and Ischemic Heart Disease Mortality Among Elderly in High Aging Asian Economies

In the epidemiological literature, the impact of environmental pollution on cardiac mortality has been well documented. There is, however, a paucity of evidence on the impact of air pollution exposure on ischemic heart disease (IHD) mortality among the Asian aged population. In response, this research seeks to investigate the degree of proximity between exposure to ambient PM2.5, household PM2.5, ground-level ozone (O3), and IHD mortality in the top seven Asian economies with the highest aging rates. This investigation is held in two phases. In the first phase, grey modeling is employed to assess the degree of proximity among the selected variables, and then rank them based on their estimated grey weights. In addition, a grey-based Technique for Order of Preference by Similarity to Ideal Solution (G-TOPSIS) is adopted to identify the key influencing factor that intensifies IHD mortality across the selected Asian economies. According to the estimated results, South Korea was the most afflicted nation in terms of IHD mortality owing to ambient PM2.5 and ground-level O3 exposure, whereas among the studied nations India was the biggest contributor to raising IHD mortality due to household PM2.5 exposure. Further, the outcomes of G-TOPSIS highlighted that exposure to household PM2.5 is a key influencing risk factor for increased IHD mortality in these regions, outweighing all other air pollutants. In conclusion, this grey assessment may enable policymakers to target more vulnerable individuals based on scientific facts and promote regional environmental justice. Stronger emission regulations will also be required to mitigate the adverse health outcomes associated with air pollution exposure, particularly in regions with a higher elderly population.

Impact of Environmental Degradation on Human Health: An Assessment Using Multicriteria Decision Making

Air pollution has emerged as a major global concern in recent decades as a result of rapid urbanization and industrialization, leading to a variety of adverse health outcomes. This research aims to investigate the influence of exposure to ambient and household particulate matter pollution (PM_2.5), and ground-level ozone (O₃) pollution on respiratory and cardiac mortality in Pakistan. We used grey incidence analysis (GIA) methodology to estimate the degree of proximity among selected variables and rank them based on mortality. Hurwicz's criterion is then adopted for further optimization by prioritizing the selected factors with the greatest influence on respiratory and cardiac mortality. The GIA findings revealed that asthma mortality is considerably impacted by exposure to ambient and household PM_2.5 concentration while ischemic heart disease (IHD) mortality is potentially influenced by ground-level ozone exposure. Furthermore, results based on Hurwicz's analysis demonstrated that exposure to ambient PM_2.5 concentration appeared as the most intensified factor of respiratory and cardiac mortality. This corroboration adds to the growing body of research demonstrating that exposure to ambient PM_2.5 adversely leads to respiratory and cardiac risks, emphasizing the demand for further improvement of air quality in Pakistan. Besides, the suggested methodologies provide a valuable tool and additional practical knowledge for policymakers and decision-makers in drawing rational decisions.

Significant production of vanillin and in vitro amplification of ech gene in local bacterial isolates

Vanillin is the major component which is responsible for flavor and aroma of vanilla extract and is produced by 3 ways: natural extraction from vanilla plant, chemical synthesis and from microbial transformation. Current research was aimed to study bacterial production of vanillin from native natural sources including sewage and soil from industrial areas. The main objective was vanillin bio-production by isolating bacteria from these native sources. Also to adapt methodologies to improve vanillin production by optimized fermentation media and growth conditions. 47 soil and 13 sewage samples were collected from different industrial regions of Lahore, Gujranwala, Faisalabad and Kasur. 67.7% bacterial isolates produced vanillin and 32.3% were non-producers. From these 279 producers, 4 bacterial isolates selected as significant producers were; A3, A4, A7 and A10. These isolates were identified by ribotyping as A3 Pseudomonas fluorescence (KF408302), A4 Enterococcus faecium (KT356807), A7 Alcaligenes faecalis (MW422815) and A10 Bacillus subtilis (KT962919). Vanillin producers were further tested for improved production of vanillin and were grown in different fermentation media under optimized growth conditions for enhanced production of vanillin. The fermentation media (FM) were; clove oil based, rice bran waste (residues oil) based, wheat bran based and modified isoeugenol based. In FM5, FM21, FM22, FM23, FM24, FM30, FM31, FM32, FM34, FM35, FM36, and FM37, the selected 4 bacterial strains produced significant amounts of vanillin. A10 B. subtilis produced maximum amount of vanillin. This strain produced 17.3 g/L vanillin in FM36. Cost of this fermentation medium 36 was 131.5 rupees/L. This fermentation medium was modified isoeugenol based medium with 1% of isoeugenol and 2.5 g/L soybean meal. ech gene was amplified in A3 P. fluorescence using ech specific primers. As vanillin use as flavor has increased tremendously, the bioproduction of vanillin must be focused.

Association of Mortality-Related Risk Factors in Patients with COVID-19: A Retrospective Cohort Study

COVID-19 is a rapidly disseminating infectious disease conferred by the World Health Organization (WHO) as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics data have been identified for patients with COVID-19, but mortality-related risk factors and a comprehensive clinical course of disease in a developing country have not been specifically defined. This retrospective, single-center cohort study involved all successive inpatients having a positive COVID-19 polymerase chain reaction (PCR), with deceased or discharged clinical outcomes from 1 January to 10 May 2021. Data were extracted from electronic medical records on demographic, clinical, radiological, and laboratory findings as well as complications faced and treatment provided during follow-up, involving serial samples for viral RNA identification, and compared between the dead and survivors. To investigate the risk factors associated with in-hospital mortality, we employed the multivariate logistic regression model. In this study, 2048 patients were involved, 1458 of whom were discharged, and 590 died in hospital. More than half of patients were identified as male with old age being the potential risk factor of mortality. Exactly 94.8% of all patients presented with fever at the time of admission. Several comorbidities were present in the study population, with the most frequent comorbidity being cardiovascular diseases (1177 of 2048) and hypertension (975 of 2048) followed by cerebrovascular disease and diabetes mellitus. Mortality rates for infected patients were observed as higher in severe patients (46.3%) compared with non-severe cases (26.1%) during a follow-up. Multivariate regression analysis showed a significant association of in-hospital mortality of patients with older age, presence of hypertension and cardiovascular diseases as underlying comorbidities, increased level of cardiac troponin I and d-dimer concentration on admission, as well as septicemia and ARDS as a complication during illness. To minimize the risk of death in COVID19 patients, as well as the risk of severe complications, urgent public health measures should be properly planned and implemented on those vulnerable populations. To detect early manifestations of clinical problems, thorough and regular follow-up is warranted.

555 Should All Acutely Presenting Gallstone Disease Be Managed Surgically?

Aim

This audit aims to assess if gallstone complications can be prevented by performing an emergency cholecystectomy in acutely presenting gallstone disease. Factors taken into consideration include number of presentations to hospital before surgery, secondary admissions of pancreatitis or cholangitis, subsequent requirements of ERCP as well as complication rates of elective and emergency surgery.

Method

Retrospective audit looking at 387 cholecystectomies carried out, within a year, at Walsall Manor Hospital.

Results

Approximately 20% of patients had an emergency cholecystectomy. A total of 192 patients had at least one admission, with 17% having a minimum second. Seven patients went on to develop gallstone pancreatitis subsequently, as well as eight requiring at least a minimum of one ERCP. The complication rate in elective surgery was higher at 4.1% compared to 2.7% in emergency cases. Long waiting times for surgery put patients at greater risk of complications. 96% (26/27) of elective cholecystectomy patients, who suffered an attack of pancreatitis, had to wait more than four weeks. Furthermore, 39% (47/119) of those who had a minimum of one admission had to wait more than 20 weeks. On the other hand, three-quarters of patients who were operated in emergency went home within 48 hours, with the figures being not too dissimilar from elective cases with a history of admission (76%).

Conclusions

Performing emergency cholecystectomies in the same admission or on a dedicated hot list would not only decrease the risk, but also the potential risk of developing gallstone complications.

Modulating the production of xylanase by Bacillus pumilus BS131 through optimization using waste fiber sludge

In recent days, cheapest alternative carbon source for fermentation purpose is desirable to minimize production cost. Xylanases have become attractive enzymes as their potential in bio-bleaching of pulp and paper industry. The objective of the present study was to identify the potential ability on the xylanase production by locally isolated Bacillus pumilus BS131 by using waste fiber sludge and wheat bran media under submerged fermentation. Culture growth conditions were optimized to obtain significant amount of xylanase. Maximum xylanase production was recorded after 72 hours of incubation at 30 °C and 7 pH with 4.0% substrate concentration. In the nutshell, the production of xylanase using inexpensive waste fiber sludge and wheat-bran as an alternative in place of expensive xylan substrate was more cost effective and environment friendly.

Whole sugar 2,3-butanediol fermentation for oil palm empty fruit bunches biorefinery by a newly isolated Klebsiella pneumoniae PM2

Effective utilization of cellulose and hemicelluloses is essential to sustainable bioconversion of lignocellulose. A newly isolated xylose-utilizing strain, Klebsiella pneumoniae PM2, was introduced to convert the biomass "whole sugars" into high value 2,3-butanediol (2,3-BDO) in a biorefinery process. The fermentation conditions were optimized (30°C, pH 7, and 150 rpm agitation) using glucose for maximum 2,3-BDO production in batch systems. A sulfite pretreated oil palm empty fruit bunches (EFB) whole slurry (substrate hydrolysate 119.5 g/L total glucose mixed with pretreatment spent liquor 80 g/L xylose) was fed to strain PM2 for fermentation. The optimized biorefinery process resulted in 75.03 ± 3.17 g/L of 2,3-BDO with 0.78 ± 0.33 g/L/h productivity and 0.43 g/g yield (87% of theoretical value) via a modified staged separate hydrolysis and fermentation process. This result is equivalent to approximately 135 kg 2,3-BDO and 14.5 kg acetoin precursors from 1 ton of EFB biomass without any wastage of both C₆ and C₅ sugars.

Cardiovascular disease (CVD): assessment, prediction and policy implications

BACKGROUND

The study aims to predict and assess cardiovascular disease (CVD) patterns in highly affected countries such as Pakistan, India, China, Kenya, the USA, and Sweden. The data for CVD deaths was gathered from 2005 to 2019.

METHODS

We utilized non-homogenous discrete grey model (NDGM) to predict growth of cardiovascular deaths in selected countries. We take this process a step further by utilizing novel Synthetic Relative Growth Rate (RGR) and Synthetic Doubling Time (Dt) model to assess how many years it takes to reduce the cardiovascular deaths double in numbers.

RESULTS

The results reveal that the USA and China may lead in terms of raising its number of deaths caused by CVDs till 2027. However, doubling time model suggests that USA may require 2.3 years in reducing the cardiovascular deaths.

CONCLUSIONS

This study is significant for the policymakers and health practitioners to ensure the execution of CVD prevention measures to overcome the growing burden of CVD deaths.

Genome Wide Identification and Comparative Analysis of the Serpin Gene Family in Brachypodium and Barley

Serpins (serine protease inhibitors) constitute one of the largest and most widely distributed superfamilies of protease inhibitors and have been identified in nearly all organisms. To gain significant insights, a comprehensive in silico analysis of the serpin gene family was carried out in the model plant for temperate grasses Brachypodium distachyon and barley Hordeum vulgare using bioinformatic tools at the genome level for the first time. We identified a total of 27 BdSRPs and 25 HvSRP genes in Brachypodium and barley, respectively, showing an unexpectedly high gene number in these model plants. Gene structure, conserved motifs and phylogenetic comparisons of serpin genes supported the role of duplication events in the expansion and evolution of serpin gene family. Further, purifying selection pressure was found to be a main driving force in the evolution of serpin genes. Genome synteny analysis indicated that BdSRP genes were present in syntenic regions of barley, rice, sorghum and maize, suggesting that they evolved before the divergence of these species from common ancestor. The distinct expression pattern in specific tissues further suggested a specialization of functions during development and in plant defense. These results suggest that the LR serpins (serpins with Leu-Arg residues at P2-P1') identified here can be utilized as candidates for exploitation in disease resistance, pest control and preventing stress-induced cell death. Additionally, serpins were identified that could lead to further research aimed at validating and functionally characterizing the role of potential serpin genes from other plants.

Identification of novel vaccine candidates against carbapenem resistant Klebsiella pneumoniae: A systematic reverse proteomic approach

Klebsiella pneumoniae is declared as antibiotic resistant by WHO, with the critical urgency of developing novel antimicrobial therapeutics as drug resistance is the second most dangerous threat after terrorism. Besides many attempts still, there is no effective vaccine available against K. pneumoniae. By utilizing all the available proteomic data we prioritized the novel proteins ideal for vaccine development using bioinformatics tools and techniques. Among the huge data, eight proteins passed all the barriers and were considered ideal candidates for vaccine development. These include: copper silver efflux system outer membrane protein (CusC), outer membrane porin protein (OmpN), Fe⁺⁺ enterobactin transporter substrate binding protein (fepB), zinc transporter substrate binding protein (ZnuA), ribonuclease HI, tellurite resistant methyltransferase (the B), and two uncharacterized hypothetical proteins (WP_002918223 and WP_002892366). These proteins were also subjected to epitope analysis and were found best for developing subunit vaccine against K. pneumoniae. The study shows that the potential vaccine targets are sufficiently efficient being virulent, of outer membranous origin and can be proposed for the DNA third-generation vaccines development that would help to cope up infections caused by multidrug-resistant K. pneumoniae.

Setting performance benchmarks for stroke care delivery: Which quality indicators should be prioritized in quality improvement; an analysis in 500,331 stroke admissions

BACKGROUND AND AIM

Benchmarking is a management approach for implementing best medical practices at the lowest cost. The objectives of this study were to set achievable performance benchmarks for individual quality indicators to determine the predicted quality achievement related to better adherence, and to select optimal quality indicators for improving the quality of acute ischemic stroke care.

METHODS

We analyzed data on 500,331 patients diagnosed with acute ischemic stroke who were treated at 518 hospitals in China from January 2011 to May 2017. The primary outcome was independence (modified Rankin Scale score ≤2) at discharge. Data-driven achievable benchmarking used the "pared-mean" approach to set objective performance targets. Hierarchical logistic regression models were employed to evaluate the process-outcome association, as well as the predicted quality improvement if all hospitals were to operate at the benchmark level.

RESULTS

Of the overall population, 64.01% were independent patients at discharge. The performance benchmarks were >90% for most of the quality indicators. After adjusting for patient-level and hospital-level characteristics and unifying hospital performance to the benchmark level, the quality indicators with high increase in both overall adherence rate and independence rate were thrombolytic therapy, anticoagulant therapy, venous thrombosis prophylaxis.

CONCLUSIONS

Performance targets for three acute treatments, including thrombolytic therapy, anticoagulant therapy, venous thrombosis prophylaxis, could best motivate improvements in both overall adherence rate and independence rate at discharge. The finding suggests that the above three types of acute treatment should be given priority to improve the quality of acute ischemic stroke care.

Sectoral-based CO2 emissions of Pakistan: a novel Grey Relation Analysis (GRA) approach

Global warming regarded as the major global issue over the past few decades, whereas carbon dioxide (CO₂) emissions have been cited as one of the main causes of this problem. Therefore, this study aims to investigate the effect of energy consumption, economic development, and population growth on high CO₂ emitting sectors of Pakistan such as transportation, industrial, and household. The data used in this study was taken from multiple databases from 2000 to 2018. We employed novel grey relational analysis (GRA) models to assess the connection between gross domestic product (GDP) per capita, population, energy consumption, and CO₂ emission. Furthermore, the Hurwicz method was used to analyze which factor contributing more to CO₂ emission. Result reveals that CO₂ emission, gross domestic product per capita, population, and energy consumption showed a strong association among all sectors. Whereas, population contributes more to intensifying CO₂ emissions in the transportation sector of Pakistan. This study provides useful insights for policymakers to take preventive and corrective measures to overcome CO₂ emissions as well as sustainable development.

An overview on red algae bioactive compounds and their pharmaceutical applications

Objectives To review red algae bioactive compounds and their pharmaceutical applications. Content Seaweed sources are becoming attractive to be used in health and therapeutics. Among these red algae is the largest group containing bioactive compounds utilized in cosmetic, pharmaceutical, food industry, manure and various supplements in food formula. Various significant bioactive compounds such as polysaccharides (aginate, agar, and carrageenan), lipids and polyphenols, steroids, glycosides, flavanoids, tannins, saponins, alkaloids, triterpenoids, antheraquinones and cardiac glycosides have been reported in red algae. The red algae have rich nutritional components Different polysaccharides of red algae possess the antiviral potential namely agarans, carrageenan, alginate, fucan, laminaran and naviculan. Sulfated polysaccharides and carraginans of red algae are rich source of soluble fibers which can account for antitumor activities depending upon chemistry of various secondary metabolites and metabolism of cell line. Flavons-3-ols containing catechins from many red algae block the telomerase activity in colon cancer cells. Contraceptive agents were tested from red algae as a source for post-coital. Lectin of red algae showed pro-healing properties and anti-ulcerogenic activities. Carragenates from red algae also conferred a positive influence on diabetes. Red algae depicted a reducing effect on plasma lipids and obesity. Porphyran from red alga can act as anti-hyperlipidemic agent also reduces the apolipoprotein B100 via suppression of lipid synthesis in human liver. Summary The polyphenolic extracts of Laurencia undulate, Melanothamnus afaqhusainii and Solieria robusta extract show anti-inflammatory effects against multiple genera of devastating fungi. Antioxidants such as phlorotannins, ascorbic acids, tocopherols, carotenoids from red algae showed toxicity on some cancer cells without side effects. Red algae Laurencia nipponica was found insecticidal against mosquito larvae. Red algae fibers are very important in laxative and purgative activities. Gracilaria tenuistipitat resisted in agricultural lands polluted with cadmium and copper. Outlook In the recent decades biotechnological applications of red algae has been increased. Polysaccharides derived from red algae are important tool for formulation of drugs delivery system via nanotechnology.

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

BACKGROUND

This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery.

METHODS

This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery.

RESULTS

A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498).

CONCLUSION

There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

Synthesis of Dy-Y co-substituted manganese‑zinc spinel nanoferrites induced anti-bacterial and anti-cancer activities: Comparison between sonochemical and sol-gel auto-combustion methods

This study described the beneficial properties of ultrasonic irradiation approach to synthesize the spinel-type Dy-Y co-substituted Mn-Zn nanospinel ferrites (NSFs). We have used two different approaches like citrate sol-gel combustion and ultrasonic irradiation routes to produced series of Mn_0.5Zn_0.5Fe_2-2x(Dy_xY_x)O₄ (0.0 ≤ x ≤ 0.05) NSFs (DyY-MnZn NSFs). The structure and morphology of NSFs X-was examined by using XRD, EDX, SEM and TEM methods. We have found that spinel ferrites and hematite phase in DyY-MnZn NSFs produced by citrate sol-gel, while DyY-MnZn NSFs created by ultrasonic irradiation contain a pure phase of spinel ferrite. TEM analysis revealed the spherical nanoparticles with fairly uniform size. We have also analyzed the biological applications of DyY-MnZn NSFs prepared by both methods (ultrasonication and sol-gel) by examining their anti-cancer and anti-bacterial (Escherichia coli and Staphylococcus aureu) activities. We have found that both methods produced inhibitory actions on colon cancer cells (HCT-116) and bacterial cells, whereas, no inhibitory action was observed when examined on normal and non-cancerous cells (HEK-293).

Synthesis of Ni0.5Co0.5-xCdxFe1.78Nd0.02O4 (x ≤ 0.25) nanofibers by using electrospinning technique induce anti-cancer and anti-bacterial activities

Here we report the electrospinning synthesis of Cd-substituted Ni-Co ferrite Ni_0.5Co_0.5-xCd_xFe_1.78Nd_0.02O₄ (x ≤ 0.25) nanofiber (NFs) with a very low concentration of Nd as a dopant. The structure and surface morphology of the Ni_0.5Co_0.5-xCd_xFe_1.78Nd_0.02O₄ (x ≤ 0.25) NFs were analyzed by X-ray powder pattern (XRD), transmission and scanning electron microscopes (TEM) along with Energy-dispersive X-ray (EDX). We have examined the biological applications of the Ni_0.5Co_0.5-xCd_xFe_1.78Nd_0.02O₄ (x ≤ 0.25) NFs on both cancerous cells and bacterial cells. We have found that Ni_0.5Co_0.5-xCd_xFe_1.78Nd_0.02O₄ (x ≤ 0.25) NFs produced inhibitory action on the human colorectal carcinoma cells (HEK-293) and also showed inhibitory action on the bacterial strains (S. aureus and E. coli) respectively. Finally, this is the first report on the synthesis of Cd- substituted Co-Ni ferrite nanofibers using electrospinning technique exhibiting anti-cancer and anti-bacterial activities.Communicated by Ramaswamy H. Sarma.

Tadalafil may improve cerebral perfusion in small-vessel occlusion stroke-a pilot study

New treatments for cerebral small-vessel disease are needed to reduce the risk of small-vessel occlusion stroke and vascular cognitive impairment. We investigated an approach targeted to the signalling molecule cyclic guanosine monophosphate, using the phosphodiesterase 5 inhibitor tadalafil, to explore if it improves cerebral blood flow and endothelial function in patients with cerebral small-vessel disease and stroke. In a randomized, double-blinded, placebo-controlled, cross-over pilot trial (NCT02801032), we included patients who had a previous (>6 months) small-vessel occlusion stroke. They received a single dose of either 20 mg tadalafil or placebo on 2 separate days at least 1 week apart. We measured the following: baseline MRI for lesion load, repeated measurements of blood flow velocity in the middle cerebral artery by transcranial Doppler, blood oxygen saturation in the cortical microvasculature by near-infrared spectroscopy, peripheral endothelial response by EndoPAT and endothelial-specific blood biomarkers. Twenty patients with cerebral small-vessel disease stroke (3 women, 17 men), mean age 67.1 ± 9.6, were included. The baseline mean values ± standard deviations were as follows: blood flow velocity in the middle cerebral artery, 57.4 ± 10.8 cm/s; blood oxygen saturation in the cortical microvasculature, 67.0 ± 8.2%; systolic blood pressure, 145.8 ± 19.5 mmHg; and diastolic blood pressure, 81.3 ± 9.1 mmHg. We found that tadalafil significantly increased blood oxygen saturation in the cortical microvasculature at 180 min post-administration with a mean difference of 1.57 ± 3.02%. However, we saw no significant differences in transcranial Doppler measurements over time. Tadalafil had no effects on peripheral endothelial function assessed by EndoPAT and endothelial biomarker results conflicted. Our findings suggest that tadalafil may improve vascular parameters in patients with cerebral small-vessel disease stroke, although the effect size was small. Increased oxygenation of cerebral microvasculature during tadalafil treatment indicated improved perfusion in the cerebral microvasculature, theoretically presenting an attractive new therapeutic target in cerebral small-vessel disease. Future studies of the effect of long-term tadalafil treatment on cerebrovascular reactivity and endothelial function are needed to evaluate general microvascular changes and effects in cerebral small-vessel disease and stroke.

Sustainability metrics of pretreatment processes in a waste derived lignocellulosic biomass biorefinery

Excessive utilization of fossil fuels has resulted in serious concerns about climate change. Integrating biorefinery technology to convert waste-derived-lignocellulosic biomass into biofuels and biopolymers has become an emerging topic toward our sustainable future. Pretreatment to fractionate the building block chemicals from the biomass is a crucial unit operation to ease the downstream processes in biorefinery. However, application of solvents and chemicals in the process can create many operational and environmental challenges in sensitive areas like highly populated cities. To shed light on how to determine a green biorefinery, this study presents the sustainability metrics of various pretreatment techniques and their operational risks during urbanization. The proposed green indexes include fractionation outputs, chemical recyclability, operational profile, and safety factors. In line with the design principles of lignin valorization, the issue of urban biomass and water-and-energy nexus are addressed to support future development and application of urban biorefinery for municipal waste management.

METASTATIC HÜRTHLE CELL CARCINOMA PRESENTING WITH LOW FREE THYROXINE, SEVERE HYPERCALCEMIA AND SPURIOUS GROWTH HORMONE PRODUCTION

Objective

Hürthle cell tumors constitute about 5% of thyroid neoplasms. They have malignant potential, behaving very aggressively compared to other differentiated thyroid cancers. The objective of this case report is to describe a case of a Hürthle cell carcinoma with a single large metastasis in the liver presenting almost 17 years after hemithyroidectomy. We highlight the difficulties in making a histologic diagnosis and the unpredictable nature of this cancer.

Methods

The patient history and biochemistry were detailed. Thyroid function tests analyzed on multiple platforms (single-photon emission computed tomography, dynamic magnetic resonance imaging, technetium-99m bone scan, and radioactive iodine) were used to aid biochemical and radiologic diagnosis.

Results

The patient's thyroid function test showed persistently low free thyroxine concentrations with normal thyroid stimulating hormone and free triiodothyronine, suggesting rapid deiodination in the context of a large liver lesion. Radiologic and morphologic appearances of the liver lesion led to an initial misdiagnosis of primary hepato-cellular carcinoma, revised to metastatic Hürthle cell carcinoma after positive immunochemistry. Nonparathyroid hormone-related intractable hypercalcemia of malignancy with an unusual pattern of elevated 1,25-dihydroxyvitamin D and raised fibroblast growth factor 23 concentrations culminated in his demise.

Conclusions

In Hürthle cell carcinomas treated with partial thyroidectomy, subsequent abnormal thyroid functions tests may herald a more sinister underlying diagnosis. The management of Hürthle cell carcinoma relies heavily on the initial histology results. Histologic diagnosis should be sought earlier in abnormal and suspicious distant masses. Malignant hypercalcemia poses a great challenge in delayed presentations and can prove resistant to conventional treatments.

Synthesis and biological characterization of Mn0.5Zn0.5EuxDyxFe1.8-2xO4 nanoparticles by sonochemical approach

Metallic nanoparticles (NPs) possess unique properties which makes them attractive candidates for various applications especially in field of experimental medicine and drug delivery. Many approaches were developed to synthesize divers and customized metallic NPs that can be useful in many areas such as, experimental medicine, drug design, drug delivery, electrical and electronic engineering, electrochemical sensors, and biochemical sensors. Among different metallic nanoparticles, manganese (Mn) NPs are the most prominent materials, in the present study, we have synthetized unique Mn_0.5Zn_0.5Dy_xEu_xFe_1.8-2xO₄ NPs by using ultrasonication method (x ≤ 0.1). The structure, and surface morphology of Mn_0.5Zn_0.5Dy_xEu_xFe_1.8-2xO₄ NPs was characterized by XRD, SEM, TEM and EDX methods. We have examined the biological effects of Mn_0.5Zn_0.5Dy_xEu_xFe_1.8-2xO₄ NPs on both normal (HEK-293) and cancerous (HCT-116) cells. We have found that the treatment of Mn_0.5Zn_0.5Dy_xEu_xFe_1.8-2xO₄ NPs post 48 h, showed significant decline in cancer cells population as revealed by MTT assay. The IC₅₀ value of Mn_0.5Zn_0.5Dy_xEu_xFe_1.8-2xO₄ NPs was ranged between (2.35 μg/mL to 2.33 μg/mL). To check the specificity of the actions, we found that the treatment of Mn_0.5Zn_0.5Dy_xEu_xFe_1.8-2xO₄ NPs did not produce any effects on the normal cells, which suggest that Mn_0.5Zn_0.5Dy_xEu_xFe_1.8-2xO₄ NPs selectively targeted the cancerous cells. The anti-bacterial properties of Mn_0.5Zn_0.5Dy_xEu_xFe_1.8-2xO₄ NPs were also evaluated by MIC and MBC assays. We suggest that Mn_0.5Zn_0.5Dy_xEu_xFe_1.8-2xO₄ NPs produced by sonochemical method possess potential anti-cancer and anti-bacterial capabilities.

Xanthophyll: Health benefits and therapeutic insights

Xanthophylls constitute a major part of carotenoids in nature. They are an oxidized version of carotenoid. Xanthophyll has widely drawn scientists' attentions in terms of its functionality, bioavailability and diversity. An assortment of xanthophyll varieties includes lutein, zeaxanthin, β-cryptoxanthin, capsanthin, astaxanthin, and fucoxanthin. Chemically, lutein and zeaxanthin are dipolar carotenoids with hydroxyl groups at both ends of their molecules that bestow hydrophilic properties to them. Hydrophilic affinity in lutein and zeaxanthin makes better bioavailability in reaction with singlet oxygen in water phase, whereas non-polar carotenoids have shown to have less efficiency in scavenging free radicals. Xanthophylls have been studied for their effects in a wide variety of diseases including neurologic, ophthalmologic, oral, allergic and immune diseases. This review highlights pharmaco-pharmaceutical applications of xanthophylls as well asits drug interactions with beta-carotene. Different types of xanthophylls have been shown to have neuroprotective effects. Fucoxanthin demonstrated potent antiplasmodial activity. Lutein and zeaxanthin prevent the progression of age related macular degeneration. They have also demonstrated promising effects on uveitis, retinitis pigmentosa, scleritis, cataracts, glaucoma, retinal ischemia and choroideremia. Astaxanthin showed to have skin protecting effects against ultraviolet light injury. Astaxanthin have anti-allergic activity against the contact dermatitis especially to treat the patients having adverse reactions induced by steroids. Astaxanthin has been reported to exert beneficial effects in preventing oral lichen planus and early stage cancers. β-cryptoxanthin has been considered a good candidate for prevention of bone loss via osteoblastic bone formation and inhibiting osteoclastic bone resorption. There is also some concern that higher dose of xanthophylls may be linked to increased risk of skin cancer and gastric adenocarcinoma. However this increased risk was not statistically significant when adjusted for confounding factors. Further researches including clinical studies are needed to better evaluate the efficacy and safety of xanthophylls in prevention and treatment of different diseases.