Improved functionalization of oleic acid-coated iron oxide nanoparticles for biomedical applications

Superparamagnetic iron oxide nanoparticles can providemultiple benefits for biomedical applications in aqueous environments such asmagnetic separation or magnetic resonance imaging. To increase the colloidal stability and allow subsequent reactions, the introduction of hydrophilic functional groups onto the particles’ surface is essential. During this process, the original coating is exchanged by preferably covalently bonded ligands such as trialkoxysilanes. The duration of the silane exchange reaction, which commonly takes more than 24 h, is an important drawback for this approach. In this paper, we present a novel method, which introduces ultrasonication as an energy source to dramatically accelerate this process, resulting in high-quality waterdispersible nanoparticles around 10 nmin size. To prove the generic character, different functional groups were introduced on the surface including polyethylene glycol chains, carboxylic acid, amine, and thiol groups. Their colloidal stability in various aqueous buffer solutions as well as human plasma and serum was investigated to allow implementation in biomedical and sensing applications.status: publishe

Dementia incidence among a cohort of lebanese older adults: first incidence estimates from the Middle East and North Africa region

ObjectiveTo provide the first estimates of dementia incidence rates among elderly in Lebanon.MethodsThe cohort established in 2013 consisted of 470 elderly from Beirut and Mount Lebanon, who consented to be followed-up. In 2017, we reached 341 participants/informants, achieving a response rate of 72.6%. The validated Arabic version of the 10/66 Dementia Research Group diagnostic tool was administered through face-to-face interviews. Direct age standardization was applied to the data using the Western European population distribution. Age-, sex- and location-specific incidence rates were estimated.ResultsAfter 3.5 years of follow up, 19 new cases of dementia were identified among 229 surviving participants. The crude incidence rate was 16.8 per 1,000 p-y, and the age standardized rate was 20.5 per 1,000 p-y. The incidence rate increased with age, going from 6.5 for those aged 65–74 years to 54.0 for those aged 85–89 years. Incidence rate was higher among females than males (20.7 vs.12.0), and higher in Mount Lebanon, as compared to the capital city Beirut (19.5 vs.14.9).ConclusionDementia incidence rate was close to European and North American countries' estimates. The use of validated tools increased the internal validity of our results. A large cohort study is warranted to confirm these results

Blood pressure patterns in rural, semi-urban and urban children in the Ashanti region of Ghana, West Africa

BACKGROUND: High blood pressure, once rare, is rapidly becoming a major public health burden in sub-Saharan/Africa. It is unclear whether this is reflected in children. The main purpose of this study was to assess blood pressure patterns among rural, semi-urban, and urban children and to determine the association of blood pressure with locality and body mass index (BMI) in this sub-Saharan Africa setting. METHODS: We conducted a cross-sectional survey among school children aged 8–16 years in the Ashanti region of Ghana (West-Africa). There were 1277 children in the study (616 boys and 661 females). Of these 214 were from rural, 296 from semi-urban and 767 from urban settings. RESULTS: Blood pressure increased with increasing age in rural, semi-urban and urban areas, and in both boys and girls. The rural boys had a lower systolic and diastolic blood pressure than semi-urban boys (104.7/62.3 vs. 109.2/66.5; p < 0.001) and lower systolic blood pressure than urban boys (104.7 vs. 107.6; p < 0.01). Girls had a higher blood pressure than boys (109.1/66.7 vs. 107.5/63.8; p < 0.01). With the exception of a lower diastolic blood pressure amongst rural girls, no differences were found between rural girls (107.4/64.4) and semi-urban girls (108.0/66.1) and urban girls (109.8/67.5). In multiple linear regression analysis, locality and BMI were independently associated with blood pressure in both boys and girls. CONCLUSION: These findings underscore the urgent need for public health measures to prevent increasing blood pressure and its sequelae from becoming another public health burden. More work on blood pressure in children in sub-Saharan African and other developing countries is needed to prevent high blood pressure from becoming a major burden in many of these countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The heart rate response to alcohol intoxication and its relationship with alcohol consumption, delinquency, and intoxicated aggressive and disinhibited behaviors /

Alcohol abuse/dependence frequently co-occurs with antisocial personality disorder (ASPD) and conduct disorder (CD). Furthermore, crime studies have generally found that alcohol is involved in over 50% of violent crimes, and experimental studies support the notion that acute alcohol consumption indirectly increases the likelihood of aggressive and disinhibited behaviors in the laboratory. However, the mechanisms underlying alcohol's association with such behaviors remain unclear. The goals of this thesis were therefore to further elucidate potential mechanisms underlying (a) alcohol-induced aggressive, disinhibited behaviors and (b) the high comorbidity between delinquent, aggressive behaviors (characterizing CD/ASPD) and alcohol misuse/abuse/dependence. Thus, four studies were conducted, focusing on individual differences in the physiological response to alcohol intoxication. Specifically examined was the elevated heart rate (HR) response to alcohol, which is thought to reflect an increased sensitivity to alcohol-induced reward.Results of Study I indicated that high HR Responders to alcohol self-reported increased multiple year delinquency (physical aggression, theft, and destruction of property), as well as more alcohol consumption and an increased positive subjective feeling following intoxication, as compared to low HR Responders. Furthermore, a high HR response was related to increased extraversion, disinhibition, boredom susceptibility, and total sensation seeking. Study II revealed that Aggressive Sons of Male Alcoholics (Agg-SOMAs) had the highest intoxicated HR response, and reported the most alcohol consumption, as compared to Non-Agg-SOMAs, or Agg - or Non-Agg - Non-SOMAs. Studies III and IV revealed that intoxicated high HR responders exhibited the most physical aggression (assessed by the Taylor Aggression Paradigm), as well as the most behavioral disinhibition (assessed by the Go/No-Go task) as compared to sober high HR Responders, or sober/intoxicated low HR responders.In summary, individuals with a high HR response to alcohol appear to have an increased propensity for multiple addictive, disinhibited and aggressive behaviors. This determines a phenotype of both potential heuristic and clinical importance. These findings are discussed within the context of a hypothetical model of (a) the high comorbidity between alcohol use/misuse and aggression/ASPD, and (b) the increased likelihood of alcohol-induced aggressive, disinhibited behaviors

A rare presentation of pulmonary transthyretin amyloidosis

Virchow described amyloidosis in 1853. Amyloidosis is the extracellular deposition of an insoluble misfolded polymerized tetramer of fibrillary protein that accumulates within tissues leading to organ dysfunction. Amyloidosis affects 10 people per one million every year. Specific varieties of amyloidosis result from diversely involved proteins. Tissue involvement can lead to multiorgan system dysfunction. Lung involvement from amyloidosis is very rare, and tissue biopsy is crucial for diagnosis. Genetic testing might be requested based on the suspected type. Lung involvement is very rare and mainly asymptomatic, and some cases are only diagnosed postmortem. When symptomatic, the clinical manifestations are nonspecific and include cough, dyspnea, and respiratory infections. The infiltrative process might affect pulmonary mechanics producing abnormal pulmonary function testing. Radiological manifestations of pulmonary amyloidosis involve the pleura, the tracheobronchial tree, the alveoli, and the mediastinal lymph nodes. Treatment of pulmonary amyloidosis is based on treating the underlying disease process. We present herein a case of 78-year-old male with senile cardiac amyloidosis, who presents to our clinic with multiple nodular pulmonary opacities