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Background: Microorganisms belonging to Streptomyces sp. are Gram-positive bacteria known for their unsurpassed capacity for the production of secondary metabolites with diverse biological activities. The aim of this study was to evaluate the antimicrobial and antioxidant properties of ethyl acetate Streptomyces sp. PERM2 extract, its potential modes of action and bioactive secondary metabolites.Results: The ethyl acetate PERM2 extract showed antimicrobial activity more pronounced on both Gram-positive and Gram-negative bacteria and fungi with a Minimum Inhibitory Concentration value (MIC) of 0.5 mg/mL and Minimum Bactericidal Concentration (MBC) of 2 - 4 mg/mL against bacterial pathogens. MIC value against pathogenic fungi was 2 mg/mL and Minimum Fungicidal Concentration (MFC) of 0.01 - 0.05 mg/mL against pathogenic fungi. PERM2 crude extract showed the ability to inhibit bacteria cell wall synthesis at 0.5 and 1 MIC. The extract was found to possess dose-dependent 2,2-Diphenyl-picrylhadrazyl (DPPH) free radical scavenging and Ferric reducing activity. The gas chromatography-mass spectrometry (GC-MS) analysis revealed the presence of three major compounds identified as 9,12-octadecadienoic acid (Z, Z) (29.75%), tridecyl trifluoroacetate (24.82%) and 1-(+)-ascorbic acid 2, 6-dihexadecanoate (22.34%). The liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis revealed the presence of 22 non-volatile metabolites in PERM2 extract and only the compound 3, 30-O-dimethylellagic acid was identified. Conclusion: The results of this study indicate that ethyl acetate Streptomyces sp. PERM2 extract possesses antibacterial, antifungal, and antioxidant activities; inhibits bacteria cell wall and protein synthesis; and contains significant bioactive secondary metabolites which could be used as an alternative to multi-resistance antibiotics.

In many sectors, ranging from sports and military operations to professional settings (notably cognitive enhancement); human performance augmentation has been an enduring ambition. The idea behind this movement, known as human enhancement, has evolved over time from simple means of training to the improvement or augmentation of physical ability through recent developments in fields such as pharmaceuticals and implantable devices that can enhance natural abilities. They span from pharmaceutical agents to wearable technologies used for sophisticated self-experimentation, which offer promise but also present ethical, health, and societal risks Performance-Enhancing Drugs are used to enhance the performance of humans in one way or another as a basic idea. The categories of Performance Enhancing Drugs (PEDs) included are Stimulants: Stimulant drugs, including amphetamines and caffeine (in the form of coffee) have been used for thousands of endeavours and physical stamina for decades. There have been many sources of controversy in the sporting world due to use or misuse and side-effectual restrictions. The release of neurotransmitters such as dopamine and allowing muscles to grow big, and fast. Nevertheless, the consumption of anabolic steroids is strictly controlled because it has side effects and complications such as liver damage, hormonal imbalances, and greater aggression. Erythropoietin EPO is a hormone that produces red blood cells, and increased oxygen delivery to muscle. EPO Athletes and even more notably endurance athletes (such as cyclists) have a storied history of abusing this performance-enhancing agent to build stamina. However, the misuse of this drug can be very hazardous, as it causes complications such as blood clotting and heart issues.

Objective: This research was conducted to determine medication compliance and factors affecting compliance with type 2 diabetes patients in public hospitals.Method: This research is a descriptive type of research, which is one of the Quantitative research types. There was no sample selection in the study, and the study was conducted with 100 patients who met the Inclusion criteria. Research data was collected between December 2022 and June 2023. Results: The patients ' compliance with the medication appears to be at a moderate level. The difference in the Medication Compliance Reporting scale mean scores difference According to the patients' genders, whom they live with, marital status, diabetes duration, treatment method, and daily insulin application the status is not statistically significant. Conclusion: In this study, it was determined that the medication compliance of elderly type 2 diabetic patients was at a moderate level. It is recommended That nurses organize awareness training on the factors affecting medication compliance of elderly type 2 diabetic patients and That the research be conducted​ with a larger sample group.

Background and importance: Sacral fractures often lead to injuries of the lumbosacral nerve, which will cause tremendous damage to the patient’s motor and sensory functions. At present, the most commonly used surgical method is the posterior median approach, the extent and degree of neurolysis are often insufficient, so the effect of neurolysis is not well, and the functional recovery of patients after operation is often incomplete.Clinical presentation: The patient was a 17-year-old male who accidentally fell from a height and landed on his hip. The main clinical feature of the patient was persistent radiating pain in the right lower extremity with right lower limb sensorimotor disorder. The results of the X-ray examination indicated a sacral fracture and a right pubic fracture. After the injury, the patient underwent pelvic internal fixation surgery within 72 hours. Then 6 months after the surgery, there was no significant improvement in right lower limb function, and the patient came to our hospital seeking treatment. Considering the severe lumbosacral plexus injury and the history of surgery, we performed an “Anterior surgery approach combined with posterior approach for lumbosacral neurolysis” for the patient, postoperative radiation pain disappeared completely, and there were significant improvements in the muscle strength of some muscles and sensory function.Conclusion: The relaxation of the lumbosacral plexus is usually performed through a single surgical approach, which has great limitations in the effect of relaxation. Here, we demonstrate a case in which posterior lumbar incision and anterior laparoscopic lumbosacral plexus neurolysis can benefit the patient, the lumbosacral nerve was released to a great extent. We aim to bring this case to the attention of our worldwide neurosurgical colleagues and share our surgical approach to assist those who may encounter this case in the future.

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age, characterized by ovarian dysfunction and a leading cause of infertility due to ovulatory issues. Lifestyle interventions, including dietary modifications, exercise, and weight management, are considered first-line therapies for women with PCOS; however, the optimal treatment remains unidentified. The Fertility Diet (FD), introduced in 2007, represents a dietary approach that may positively impact fertility by emphasizing specific micronutrients, dietary composition modifications, weight management, and increased physical activity. This narrative review aims to evaluate how various components of the Fertility Diet influence ovulation and overall fertility, assessed through a fertility diet score. The findings of this study suggest that adherence to the Fertility Diet, particularly higher intake of the monounsaturated to trans-fat ratio, and increased vegetable protein intake, may positively influence fertility outcomes in individuals with PCOS. In contrast, high consumption of animal protein and high glycemic load food may have adverse effects. However, the current evidence remains insufficient for definitive conclusions, warranting further interventional studies to explore this relationship.

The postpartum period is a phase during which various endocrine disorders may arise due to changes in the immune system. Postpartum thyroiditis and postpartum hypophysitis (lymphocytic hypophysitis) are two autoimmune diseases that typically occur independently but are rarely found together in the same patient.Postpartum thyroiditis usually starts with thyrotoxicosis and progresses to hypothyroidism, while postpartum hypophysitis can lead to adrenal insufficiency and dysfunction of other pituitary hormones.This case report discusses a female patient who presented with severe headaches, fatigue, and hypotension five months after childbirth. The patient was diagnosed with both postpartum thyroiditis and postpartum hypophysitis simultaneously, and dysfunction of both the thyroid and pituitary was detected. Hormone replacement therapies were administered, and the patient’s symptoms were brought under control.This case emphasizes the importance of carefully evaluating both thyroid and pituitary function during the postpartum period. Early diagnosis and appropriate treatment are crucial for preventing potential complications and improving long-term health outcomes.

The National Health Surveillance Agency (ANVISA) is a public institution created by Law 9782/1999, which integrates the field of Collective Health and acts in the prevention, control, and inspection of sanitary conditions in various sectors, such as food, health, pharmacies, hospitals, and commercial establishments. Its main objective is to guarantee the protection of public health, ensuring that products, services, and environments comply with established standards, to promote health and preventing diseases. To exercise its inspection and control function, Sanitary Surveillance has the power of sanitary police, which gives it the authority to apply necessary measures and curb practices that pose risks to the health of the population.The performance of the Sanitary Surveillance is fundamental to prevent health risks in any part of society and to guarantee national programs for patient safety. It is also essential to prevent diseases, control risks, and monitor compliance with health standards and specific regulations. The police power of Sanitary Surveillance consists of establishing norms and technical regulations, carrying out inspections and inspections, issuing temporary or permanent interdiction orders in establishments that do not comply with the norms, as well as forwarding complaints to the Public Ministry in cases of crimes against public health. Arrests carried out by Sanitary Surveillance agents are extreme measures and applied in serious situations of risk to public health or when there is repeated disrespect for sanitary regulations. The prohibited establishments have the right of defense and may seek to regularize the situation to obtain the release of activities.The performance of the Sanitary Surveillance has significant impacts on the prevention of disease outbreaks and epidemics. Identifying and correcting inappropriate practices helps to prevent the spread of pathogenic agents and reduce the risk of contagion in collective environments. The institution’s preventive and supervisory activities contribute to reducing risks to the population’s health, preventing disease outbreaks, food poisoning, and the proliferation of pests, among other problems. Finally, the importance of exercising police power with transparency, impartiality, and respect for individual rights is emphasized, always aiming at the collective interest and the promotion of the common good. In summary, Health Surveillance plays an essential role in protecting public health, seeking to ensure that the population has access to safe products and services, contributing to the improvement of quality of life and disease prevention.

Cardiac arrhythmias are frequent complications of the consumption of toxic substances, including cannabis, which can be fatal.We report in this case a patient who developed a cardiac arrhythmia-type focal atrial tachycardia a few moments after the consumption of an important dose of cannabis but which reduced spontaneously and without having administered any medication or an external electric shock.All the rest of the etiological assessment of this arrhythmia was negative and the arrhythmia was linked to the consumption of cannabis which is known to cause these complications.

This document has been translated from Spanish into English using ChatGPT. While efforts have been made to ensure accuracy and maintain the original meaning, some nuances or interpretations may differ from the source text. For any clarification, please refer to the original document or contact the author.This brief article addresses the concern arising from the accelerated whirlwind of changes of all kinds experienced by our social systems, some of which have a significant evolutionary impact, largely driven by advances in science and technology. Particular interest has emerged in connecting certain properties inherent to the behavior of complex systems far from equilibrium—such as social systems—under the framework of properties currently studied in Complexity Sciences. The article outlines this concern, which is, for now, merely the beginning of what could develop into a groundbreaking investigation. It references laboratory simulation work aimed at understanding the evolutionary horizons of Chile’s social system. The text includes an example of some graphs that illustrate a potential method for detecting and anticipating possible evolutionary horizons of the social system, based on the role played by certain “attractor variables” within the system. However, the research is still exploratory, and this article serves merely as a general description of the initial concern.

Objective: To investigate the clinical significance of preoperative lower extremity venography in patients with varicose veins.Methods: From February 2019 to July 2023, 498 patients (583 diseased lower limbs) with lower limb varicose veins as the first symptom were selected and admitted to the Seventh People’s Hospital of Chongqing. Paracentesis of the deep veins of the lower extremities was performed in all affected limbs to observe the morphology of the deep veins from the ankle to the pelvis, the patency of the deep veins, and the reflux of contrast medium when the patients performed the Valsalva manoeuvre. The aetiology of varicose veins was analysed according to the imaging manifestations and individualised treatment plans were formulated according to the different aetiologies.Results: The imaging success rate of 583 diseased lower limbs was 100%, of which 285 (48.9%) were primary lower limb deep vein valve insufficiency, 186 (32%) were simple superficial varicose veins, 63 (10. 8%) were iliac vein compression syndromes, 41 (5%) were post-thrombotic syndromes of the deep veins of the lower limbs and the others (primary deep vein avascularity of the lower limbs, bifemoral venous malformations, congenital varicose vein osteohypertrophy syndrome, tumour compression, etc.) 8 articles (1.37%).Conclusion: The advantages of lower extremity deep vein bypass angiography are simple operation, low trauma, and high specificity, which can help to diagnose the aetiology of lower extremity varicose veins and guide the clinical treatment.

Public-Private Partnership (PPP) road projects are being promoted worldwide to encourage road investments; however, research on the appropriate rate of return for these projects is insufficient. This is likely because the return on investment for PPP road projects is determined through negotiations between the government and the private sector, a process that remains confidential. The rate of return for PPP road projects is not only a key indicator for evaluating project performance but also a potential driver for future government financial subsidies. Therefore, research on the appropriate rate of return for PPP road projects is necessary for the sustainability of these projects.This study, based on the concept that both the government and the private sector share the anticipated risks of the project, quantifies six types of risks and proposes a model for predicting the appropriate rate of return. The model is able to explain approximately 68% of the cases in South Korea’s PPP road projects. The risk with the greatest influence on the rate of return was found to be an economic risk, while the least influential was regulation change risk.Due to the confidentiality of data related to PPP road projects, this study only utilized 54 cases from South Korea. It is hoped that a wider range of data will be collected and further research on the appropriate rate of return will continue to enhance the sustainability of PPP road projects.

Globally, evidence-based healthcare practices are the most dependable framework for effective healthcare decisions and practices. In all nations, financial resources, people, and time are always insufficient. Healthcare professionals should recommend healthcare interventions that have been proven to be safe, effective, and affordable. All healthcare professionals must be creative to be involved in the creation and compilation of trustworthy evidence to support the decrease in morbidity and mortality of communicable and non-communicable diseases, particularly in developing nations. Regretfully, most developing nations still exhibit weaknesses and barriers to promoting health research and evidence-based healthcare. Evidence indicates that developing countries contribute 1% - 2% of health research activities to address global health problems and challenges. As a result, many individuals in these nations continue to have below-average health conditions. The lack of creativity, innovation, and motivation to gain health research competencies for healthcare professionals causes all these issues. Creativity and innovation are the foundations for the effective implementation of evidence-based healthcare. Surprisingly, no researchers have explored how creativity and innovation heighten evidence-based healthcare practices. The primary objective of this project will be to foster pathways and explore the creativity that advances health research abilities among healthcare professionals to improve evidence-based healthcare practices in resource-limited healthcare settings.

Aim: This prospective study reports the acceptance testing of the Symbia Intevo Bold SPECT/CT scanner (Siemens Healthineers), recently installed at SQCCCRC, University Medical City, Muscat, Oman, before its clinical implementation.Materials and methods: The acceptance tests were performed using a Low Energy High Resolution (LEHR) collimator and Technetium-99m (Tc-99m) as the radioactive source, following the manufacturer’s protocols. The tests included physical inspection, peaking and tuning, intrinsic and extrinsic uniformity calibration, intrinsic energy resolution, and planar spatial resolution without scatter. Key performance parameters such as full-width at half-maximum (FWHM), system sensitivity, and count rate performance were evaluated.Results: All critical acceptance tests, including intrinsic energy resolution, energy calibration (symmetric curve), and extrinsic uniformity with the LEHR collimator, were completed and met the required specifications. System sensitivity and count rate performance were within the expected ranges, confirming the system’s readiness for clinical use.Conclusion: The Symbia Intevo Bold SPECT/CT system passed all performance tests successfully. The acceptance testing validated the system’s optimal performance following international standards, ensuring its suitability for clinical operations.

The global menace of cancer requires supplementary treatments beyond standard medical approaches for effective medical intervention. The Ketogenic Diet (KD) composed of high fats combined with moderate proteins and low carbohydrates has become popular as a metabolic therapy for cancer. The anti-cancer mechanism of KD works through metabolic stress induction in cancer cells, reduced insulin and IGF-1 signaling pathways, improved mitochondrial function, inflammation, and immune regulation. Standard cancer treatments receive enhanced outcomes through KD synergistic action which simultaneously decreases treatment-related side effects. To achieve optimized treatment outcomes in cancer, ketogenic diet practitioners need to use personalized nutritional planning in combination with metabolic tracking and exogenous ketone supplements. It is essential to find solutions for diet adherence issues and nutrient deficiencies because they determine KD’s effectiveness as a cancer treatment. The fight against cancer needs sustained and multipronged clinical research and validation to establish the proper implementation of this method.

Background: Nutritional awareness among caregivers plays a crucial role in ensuring optimal pediatric health and development. This study assesses the level of nutritional awareness among caregivers and examines its association with demographic factors.Objectives: This study aimed to assess the knowledge and awareness of caregivers regarding dietary advice and complementary feeding for children under five years at Wad-Albasheir Family Health Center, Um-Bada locality.Methods: A cross-sectional study was conducted among caregivers in selected healthcare facilities. Data were collected using a structured questionnaire and analyzed using SPSS version 23. Descriptive statistics and chi-square tests were used to evaluate associations between variables.Results: The majority of caregivers demonstrated moderate awareness (60%), while 22.5% had low awareness and 17.5% had high awareness. A significant association was observed between education level and awareness (p < 0.05). Employment status also influenced awareness levels, with employed caregivers showing higher knowledge scores.Conclusion: Nutritional awareness is a key determinant of pediatric health. Strengthening educational programs targeting caregivers can improve child nutrition outcomes.

Multiple stab wounds are a critical forensic indicator, frequently linked to violent assaults, homicides, or self-inflicted injuries. These penetrating injuries result from sharp-edged weapons such as knives, daggers, or other pointed instruments. The depth, size, and severity of the wounds depend on factors including the type of weapon used, the force applied, and the anatomical location of impact. Forensic examination of stab wounds is essential in determining the manner of death—homicidal, suicidal, or accidental. Detailed analysis of wound characteristics, such as depth, trajectory, and associated injuries, aids in crime scene reconstruction. Additionally, identifying defensive wounds can indicate victim resistance, further supporting forensic interpretations. A meticulous forensic autopsy, including weapon analysis and internal organ assessment, is crucial in establishing the cause of death. These findings play a vital role in medico-legal investigations, providing key forensic evidence that supports legal proceedings and ensures justice.