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Background: Diabetes mellitus is a serious long-term condition with a major impact on the lives and well-being, of societies worldwide. Poor disposal practices of devices potentially result in personal injury and injuries to people in the household and the general community. This study aimed to assess the knowledge and self-reported practice of insulin injection device disposal and associated factors among diabetes patients in TASH, Addis Ababa, Ethiopia. Method: A cross-sectional study was conducted among 182 adults with diabetes. The study participants were selected through systematic random sampling. Data were collected from March/17/2020 - May/18/2020. Patients were interviewed using a structured questionnaire. Data were entered into Epi-data version 4. 6 and exported to SPSS version 25.0 for analysis. Bivariable and multivariable logistic regression with crude and adjusted odds ratios along with the 95% confidence interval was computed and interpreted accordingly. Good practice and adequate knowledge were defined based on median calculation; a result above the median value of good practice and adequate knowledge with a p - value < 0.05 was considered to declare a result as statistically significant.Results: About 54% of the participants had inadequate knowledge about safe insulin injection waste disposal. More than two-thirds (73%) of respondents had poor practice and 92.3% of respondents did not know how to dispose of lancets after use.Conclusion: This study revealed that the knowledge and practice of diabetic patients were inadequate and poor towards safe insulin injection waste disposal in the study area. Educating patients and awareness creation training on proper insulin injection device disposal should be considerable. 

An established side-effect of neck dissection (ND) for head and neck (HNC) tumour management includes shoulder dysfunction (SD), which can impact quality of life (QOL). Shoulder strength and range of movement (ROM) are key parameters to be monitored in SD. However, such evaluations are not routinely conducted in the clinical setting. The aim of this study was to evaluate objectively the impact of ND on shoulder functions. Methods: This is a pilot exploratory study in a tertiary cancer centre. Five participants with unilateral ND and advanced HNC, completed the study. Outcome measures consisted of self-reported QOL questionnaires, C2–T1 dermatomes and shoulder ROM and strength testing. Data was collected at baseline, 1.5-months after surgery and 6-months after diagnosis (after adjuvant treatment completion). Results: Most outcome measures on the surgically affected side were negatively impacted post-operatively, with varied recovery seen at follow-up. Sensory loss was noted at C3–4 dermatome levels. Shoulder ROM and strength was reduced on the surficial side for all participants, with some recovery after six months except for two participants.Conclusion: Results of SD after ND are diverse and unique to each patient. Findings from this pilot study indicate that regular rehabilitation/exercise may facilitate recovery of shoulder function post HNC surgery. However, customised rehabilitation may yield better outcomes. Future studies with a larger sample are indicated to validate the findings of this study.

Introduction and aim: The most accurate way of measuring kidney function in GFR. Clinical formulas based on creatinine measurement may be inaccurate mainly in elderly patients (over 80 years of age). In this study we evaluated the accuracy of commonly used clinical formulas by comparing them with a direct measurement with [99mTc]-DTPA ([99mTc]-diethylene-triamine-peracetic acid) in a population of patients aged eighty and older.Material and methods: 47 patients (27 males and 20 females) with an average age of 81.9 ± 1.7 years, 80% already diagnosed with Chronic Kidney Disease (CKD), were investigated. Two plasma samples were collected between 60-90 and 165-190 minutes after the injection of [99mTc]-DTPA and GFR were calculated. Results: When comparing the GFR values obtained from the various formulae by creatinine levels with the GFR value obtained by measuring [99mTc]-DTPA residue, the following concordance values emerged: (1) MDRD: 55.3%, (2) Cockroft-Gault 55.3% (3) CKD-EPI 57.5% (4) BIS-1 51.1%Conclusion: Our data show a poor correlation between all clinical methods and [99mTc]-DTPA, which remains a gold standard for the direct measurement of GFR.

Calcinosis cutis (CC) [1] is an unusual disorder characterized by calcium-phosphate deposition into cutaneous and subcutaneous tissues. There are five subtypes: dystrophic, metastatic, idiopathic, iatrogenic and calciphylaxis.Calciphylaxis or calcifying panniculitis is defined as small vessel calcification mainly affecting blood vessels of the dermis and subcutaneous fat. Despite the predominance of cases in patients with ESRD, calciphylaxis can also be found in patients with normal renal function and normal levels of calcium and phosphate. These cases are often referred to as nonuremic calciphylaxis (NUC), a heterogeneous category with several associations. Literature reveals an association with hyperparathyroidism (28%), malignancy (22%), alcoholic liver disease (17%) and connective tissue diseases (11%) while obesity, liver disease, high-serum calcium (Ca) × phosphorus (P) levels, combined therapies of calcium salts with vitamin D, warfarin and corticosteroids have been observed to increase the likelihood of this disease [2]. The lesions in both nonuremic and uremic calciphylaxis tend to be indistinguishable from each other, initially presenting as tender subcutaneous plaques that progress into nonhealing ulcers with overlying black eschar. Skin changes often begin with a livedo reticularis pattern that can progress to livedo racemes and ultimately retiform purpura.In our clinical case, we describe a patient with multiple risk factors for calciphylaxis, intense widespread calcification (vessels, tendons, joints) and cutaneous calcific stone of calcium and phosphate oxalate not elsewhere described before.

Background: Aautologous hematopoietic stem cell transplants (HSCT) is the standard of care for newly diagnosed patients with multiple myeloma (MM) who are eligible for autologous transplantation. Although cryopreservation is routinely employed, autologous HSCT can be performed using non-cryopreserved stem cells.Methods and materials: A retrospective study of patients with MM who received autologous HSCT between the 10th of October 2010 and the 31st of January 2022 at King Fahad Specialist Hospital (KFSH) in Dammam, Saudi Arabia was performed.Results: Over 11 years and 113 days, a total of 135 autologous HSCTs were performed for 119 patients with MM at our institution. Single autologous HSCTs were performed for 119 patients, while 16 of these patients received either planned tandem autologous transplants or second autografts due to either progression or relapse of their myeloma. The median age of patients with MM at autologous HSCT was 51.5 years. At presentation of their MM, the following high-risk (HR) features were encountered: stage III disease according to the revised international scoring system (RISS) in 12.3%; adverse cytogenetics in 31.93% of patients; advanced bone disease in 60.50%; and renal dysfunction or failure in 11.76% of patients. A total of 104 autologous HSCTs (77.04%) were performed without cryopreservation while 31 autografts (22.96%) were performed using cryopreserved apheresis stem cell products. Additionally, 54 autologous HSCTs (40.00%) were done at outpatient while 81 autografts (60.00%) were performed in an inpatient setting. Survival for 100 days post-HSCT for all patients with MM who received autologous transplants including those done at outpatient was 100%. The 4 years overall survival (OS) an progression-free survival (PFS) for patients with MM who received non- cryopreserved or fresh autologous HSCTs were 82% and 68% respectively.Conclusion: Autologous HSCT without cryopreservation is safe, and feasible and can lead to short-term as well as long-term outcomes that are comparable to autologous transplantation with cryopreservation. Non- cryopreserved autologous grafts allow the performance of autologous transplants in an outpatient setting to save beds and reduce costs.

Photocatalysis has attracted a lot of attention in recent years due to its potential in solving energy and environmental issues. Efficient light absorption and charge separation are two of the key factors for the exploration of high-performance photocatalytic systems, which are generally difficult to obtain from a single photocatalyst. The combination of various materials to form heterojunctions provides an effective way to better harvest solar energy and facilitate charge separation and transfer, thus enhancing photocatalytic activity and stability. This review concisely summarizes the recent development of visible light responsive heterojunctions, including the preparation and performance of semiconductor/semiconductor junctions and semiconductor/metal junctions and their mechanism for enhancing light harvesting and charge separation/transfer. In this regard, this review presents some unitary, binary and ternary CeO2 photocatalysts used for the degradation of organic pollutants. We expect this review to provide the type of guidelines for readers to gain a clear picture of nanotechnology and the fabrication and application of different types of heterostructured photocatalysts.

Aloe vera Linn. is an essential medicinal plant. In this present research work, a protocol of in vitro regeneration and karyomorphological analysis of Aloe vera was developed using different concentrations and compositions of media. Shoot apices of field-grown plants were used as explant and aseptically cultured on Murashige and Skoog (MS) medium fortified with different concentrations and combinations of auxins (IAA and NAA) and cytokinins (BAP and Kn). The highest number of multiple shoot buds (4.36 ± 0.07) was obtained from MS + 2.0 mg/l BAP + 1.0 mg/l IAA and induced shoot buds underwent rapid elongation (4.24 ± 0.06 cm) on the same medium composition. Half strength MS media with 2.0 mg/l IBA was suitable for induction and proliferation (6.31 ± 0.05) of roots and 95% of plantlets were acclimatized to field conditions successfully. Somatic chromosome numbers of mother and in vitro grown plants were confirmed to be 2n = 14. Chromosome length ranged from 4.28 - 13.74 µm in the naturally grown plants and 4.46 - 14.1 µm for in vitro grown plants. The total form percent (TF%) of mother and in vitro grown plants was 41.69% and 42.23%, respectively. The karyotype formula of in vivo grown plants was 2n = 14 = 4Lsm + 6Mm + 4Sm, whereas that of the micropropagated plants was 2n = 14 = 4Lsm + 4Mm + 6Sm. The frequency of the chromosome having arm more than 2:1 was 0.08 for mother plants and 0.15 for in vitro grown plants. Therefore, the karyotype of both plants falls into the 2B symmetrical type based on Stebbins classification (1971).

Agricultural land use has left its traces on the planet since sedentary agriculture started. Most of the ancient cradles of mankind and agriculture, such as the area between the rivers Euphrates and Tigris or the middle east are degraded and deserts today.

Neuropathy is when nerve damage interferes with the functioning of the peripheral nervous system (PNS). When the cause can’t be determined, it’s called idiopathic neuropathy(Idiopathic neuropathy, now designated as chronic idiopathic axonal polyneuropathy (CIAP).There are three kinds of nerves within the PNS. Sensory nerves relay messages from the sense organs to the brain. This allows sensations of temperature and touch. Motor nerves transmit signals from the brain to the muscles. This helps the brain control the muscles. Autonomic nerves control body functions like heart rate, breathing, and digestion.Damage to nerve cells can affect how the PNS communicates with the rest of the body. Symptoms can include numbness, pain, and balance issues.It’s called acute neuropathy when symptoms develop suddenly. Alternately, it’s called chronic neuropathy when symptoms start slowly and increase over time. Diagnosis involves physical examination and review of medical history. Diagnostic testing may include blood tests, nerve testing, and imaging tests.There is no cure for idiopathic neuropathy. Treatments including medication, physical therapy, and lifestyle modifications can help you function and feel better.We report a case of idiopathic polyneuropathy presented with frequent acute pulmonary edema for a year.

We developed multiple equations to observe the two and three flavors of neutrino oscillation with the mixing angle based on L/E=0.1 to 0.9 in this study. In different settings, the nature of the neutrino oscillation probability was discovered to be varied in different equations. The observation indicates increasing likelihood in one equation and decreasing probability in the other equations in two flavor oscillation neutrinos. To characterize the probability of neutrino oscillation, we use four distinct angles: 50, 100, 150, and 200. The probability of neutrino oscillation was determined to be highest at an angle of 150 degrees. However, with increasing mixing angles, the likelihood of oscillation increases on the basis of created equation (25) and decreases on the basis of equations (26) and (27) in the three-flavor neutrino oscillation. From generated equations (25) and (26) the maximum neutrino oscillation of probability is discovered at an angle of 150, however, from equation (27), the maximum probability is observed at 50. The greatest neutrino oscillation is found to be 0.9999 and the minimum is zero in all of these two and three flavors of oscillation.

Hemodialysis catheter placement, particularly Internal Jugular Catheter insertion, is a very common procedure for patients who require urgent access to renal replacement therapy. Most of these procedures are done under ultrasound guidance as recommended by KDIGO 2019 vascular access guidelines. However, catheter tip misplacement can still occur even in the experts’ hands and despite the use of ultrasound. In this case report, we will discuss a hemodialysis catheter tip placement in the right internal mammary vein and how we managed it.

The birth of a high-risk infant such as an extremely premature infant can represent an important traumatic experience for mothers. Perinatal Post Traumatic Stress Disorder Questionnaire (PPTSDQ) explores retrospectively maternal post-traumatic stress reaction. This shelf-rating questionnaire explores the potential for experiencing posttraumatic symptoms related to childbirth and the ensuing post-natal period. The PTSD questionnaire was originally developed by DeMier and Hynan and their colleagues at the University of Wisconsin and has been widely used in research and in clinical practice for identifying mothers experiencing significant emotional distress during the post-natal period, so they may be referred for mental health services. The present study aims to introduce this tool in perinatal settings as an early intervention. It has been widely used with other measures of post-traumatic stress and depression, such as the Openness Scale from the NEO-PR, the self-report measure of depression BDI-II, the IES (Impact Event Scale) and the EPDS (Edinburgh Postnatal Depression Scale). Although already a useful clinical instrument the current study used the revised version. This modification refines the response options from dichotomous choices to a Likert scale format by Callahan Borja and Hynan. Numerous qualitative and quantitative studies state that premature delivery is a highly stressful event and document the full range of post-traumatic sequelae, such as intrusive recollections, behavioral avoidance, and hyperarousal, as well as attachment difficulties following childbirth. Furthermore, the severity of neonatal complications and gestational age have been found to be predictive of PTSD symptomatology in parents as measured by the PPQ. For this reason, the current study aims to give increased focus to mothers having a premature birth and often expecting their children to die. The sample comprises 25 mothers of prematurely born infants hospitalized in the NICU and 25 mothers of full-term infants born in the maternity ward of the same Greek hospital who responded to the Perinatal PTSD Questionnaire and equally the PERI a postnatal complication rating inventory and the clinical interview for parents CLIP.Mothers of high-risk infants present post-traumatic stress reactions related to prematurity. The Perinatal PTSD Questionnaire identifies postnatal maternal distress but should not substitute a clinical interview, yet findings indicate that equally identifies pre-existing distress symptoms associated with maternal personality traits that emerged with the traumatic event of the unexpected birth.Due to the consistency of the population of the experimental group, who come mostly from the provinces, the possibility of a follow- up of the cases is quite limited.

Aim and methodology: This article describes a periodontally compromised, hopeless incisor tooth that was purposefully replanted, along with the results after six months. This entails the deliberate removal of the tooth and its subsequent correct manipulation and endodontic restoration before reinserting it into the socket.Results: Hopeless lower incisors with periodontal involvement were transplanted utilizing an implant surgical drilling approach after receiving root canal therapy and tetracycline-HCI conditioning. Bone graft material was added and the procedure was monitored for six months. The tooth was observed to be asymptomatic, functioning normally, and showing no pathologic radiological changes. With minimal bleeding during probing and no growth of pathological pockets, the periodontal condition was within normal limits. Alveolar bone support was seen to be adequate. The results may suggest that, in some circumstances, purposeful replantation is a viable strategy of treatment for maintaining native dentition.Conclusion: Intentional tooth reimplantation can be an alternative treatment option for periodontally involved teeth with poor or hopeless prognoses.

Considering the performance of supply chains in the three dimensions of sustainability; Economic, Social, and Environmental, ESG scores can function as a measurement scale [1]. Environmental, social and corporate governance (ESG) is an extension and enrichment of the concept of Socially Responsible Investment (SRI) and is an important measure of corporate sustainable development [2,3].

The search for a sustainable development path capable of satisfying the needs of the current generation without compromising the well-being of future generations is not a new challenge. In recent years, climate change and, more generally, the transition to a sustainable development model have become increasingly important. According to the European Central Bank [1], guidelines on sustainable finance, a company aims to develop value by adhering to relevant ideals, such as fair remuneration for employees, respect for ethical and social values and preservation of the environment.

Pretreatments and drying are commonly used before drying tomatoes to inactivate enzymes, improve the drying process, and improve the quality of dried tomato powders. In this review, the effects of different pretreatments (osmotic solutions), dehydration methods, and packaging materials on the quality attributes of tomato powder were summarized. These include pretreatments and osmotic agent solutions (potassium metabisulfite, calcium chloride, sodium metabisulphite, ascorbic acid, citric acid, sodium chloride, and sodium benzoate), thermal blanching (steam blanching and hot water) and non-thermal-processes-like-freezing, sulfuring, etc. and drying methods (oven, sun, and indirect solar dryer). The tomato powders were dried to preserve, store, and transport them. Drying implies not only physical changes, which the consumer can easily detect through visual inspection but also chemical modifications. These are responsible for alterations in color, flavor, and nutritional value, which compromise the overall quality of the final tomato powder. Maximum lycopene, vitamin A, and C contents were found in freeze-dried and direct sundried than samples dried using other methods at low drying temperatures. Freeze driers showed in keeping the nutritional quality of tomato powder with a combination of different pretreatments. Different pretreatments including osmotic agent solutions have their own merits and demerits for the final tomato powder. To overcome the drawbacks of nutritional quality, non-thermal pretreatment categories may be a better alternative to thermal blanching, and more fundamental research is required for better design and scale-up.

Among the conditioning factors of Diabetic Foot (DF), neuropathy is considered the main factor, arteriopathy the aggravating factor, and foot deformities the triggering factor. The preventive interventions for DF and its complications are distributed by levels of care. At the higher level, hospital care focuses on reducing DF amputations. At the lower level, Primary Care (PC) and Podiatry, focused on preventing DF. PC is considered the ideal place to identify the conditioning factors of DF. In this area, prevention follows the recommendations of the International Working Group on Diabetic Foot (IWGDF) by screening neuropathy focused on the sensitive or insensitive foot. The American Diabetes Association (ADA) a recommends person-centered assessment of neuropathy by clinical examination of symptoms and signs testing sensory, motor, and autonomic neuropathy. This controversy lead us to investigate which methodology (screening or clinical examination) could be more accurate in identifying the conditioning factors of DF in a group of people recruited in the TERMOPIEDI study. Neuropathy was assessed following the definition of diabetic neuropathy, the Young MJ diagnostic criteria, and the Toronto Council diagnostic category. These results allowed us to know the applicability of this procedure in PC within nursing competencies, detecting a greater number of patients with neuropathy compared to the screening method. People with neuropathy presented higher plantar temperature, concluding that neuropathy interferes with foot thermoregulation.

The aim of this work is to report some interesting references and documents related to the mRNA vaccine. Every cited reference can act as an instrument to better understand what some independent researchers find: this work is mainly focused on the public debate related presence/absence of graphene derivates in some vaccine vials for COVID-19. Relevant classic articles White Papers or other kinds of a document are useful instruments to better clarify some crucial aspects of this infectious disease, its epidemiology and the efficacy of the measure adopted (preventive, therapeutic, or vaccine).If the reviewed article show an intrinsic recognized international value other kinds of source like a White Paper or other documents can be of interest to generate hypotheses or to open public discussion on crucial topics. For this reason, it is useful to use this method also in the discussion related to impurity profiles in new innovative bio-pharmaceuticals like the mRNA vaccine. The fact that this product was introduced with an emergency authorization, whit reduced the time of experimentation and due to the lack of official quality information related to some raw materials used authorizes us to use also this method.Even if the international official regulatory agency does not find this substance in the control for release of the lots it is interesting to more deeply investigate what funded by an independent researcher in some vials of vaccine or sample patient’s blood after vaccination. This reference even if not a smoking gun the same can stimulate the reasoning about the general concept involved. It is needed, to read this work, to consider the intrinsic limitation of some of the study research reported (White Paper) or the other documents.

The flat foot can be defined as a syndrome with multiple etiopathogenesis, characterized by an altered structure of the longitudinal arch of the plantar vault with its reduction in height. The plantar arch collapse can be counteracted by strengthening the muscles involved; for many years, specific physical exercises have been proposed for this purpose in physical and rehabilitation medicine. Our work aimed to improve the plantar arch muscles’ tone using high focal vibration therapy (300 Hz). Methods: 49 children with a 3rd degree flat foot (age: 8,7,6) underwent 10 sessions, 2 days/wk, of 30 min of focused high vibratory therapy at a frequency of 300 Hz (Vissman, Italy). Before and after treatment stabilometry (StT), static and dynamic baropodometry tests were performed. Results: Evaluation of StT showed an improvement in stability and a decrease in the sway area and ellipse area. Baropodometry tests showed a decrease in foot surface. Also, dynamic tests showed a decrease in both foot surfaces. Discussion: The results lead us to consider this method as a method of the first choice for a conservative approach in the rehabilitation of flat foot syndrome and also for 3rd grade children [1,2].

Kinesiophobia is described as pain-related fear of movement and plays a role in the development of chronic musculoskeletal pain. Several approaches have been described in the literature, but there does not seem to be a consensus on the most appropriate way to evaluate and treat patients with kinesiophobia. The aim of this study was to identify clinically relevant assessments and treatments recommended by a consensus of experts. Fourteen experts were identified to participate in a three-round internet-based Delphi study. Participants were asked to propose assessments and treatments (round 1), to grade each proposal on a Likert scale of 9 (round 2), and to reassess their level of agreement (round 3). The consensus was defined with 75% agreement. Five methods of assessment and six treatment approaches reached a consensus. The TAMPA scale reached the top position as an assessment of kinesiophobia. Graded exposure to movement, cognitive and behavioral therapy, and pain neuroscience education were the highest-rated interventions. These results provide the first expert consensus on preferred assessments and treatments for patients with kinesiophobia and correspond with the evidence base in the literature.