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Optimization of hydrogen and syngas production from PKS gasification by using coal bottom ash

Shahbaz M, Yusup S, Inayat A, Patrick DO, Pratama A, Ammar M

Bioresour Technol, 2017 Oct;241:284-295.
PMID: 28575792 DOI: 10.1016/j.biortech.2017.05.119

Catalytic steam gasification of palm kernel shell is investigated to optimize operating parameters for hydrogen and syngas production using TGA-MS setup. RSM is used for experimental design and evaluating the effect of temperature, particle size, CaO/biomass ratio, and coal bottom ash wt% on hydrogen and syngas. Hydrogen production appears highly sensitive to all factors, especially temperature and coal bottom ash wt%. In case of syngas, the order of parametric influence is: CaO/biomass>coal bottom ash wt%>temperature>particle size. The significant catalytic effect of coal bottom ash is due to the presence of Fe2O3, MgO, Al2O3, and CaO. A temperature of 692°C, coal bottom ash wt% of 0.07, CaO/biomass of 1.42, and particle size of 0.75mm are the optimum conditions for augmented yield of hydrogen and syngas. The production of hydrogen and syngas is 1.5% higher in the pilot scale gasifier as compared to TGA-MS setup.
Appropriateness of antimicrobial prescribing in the high-burden emergency department of a tertiary hospital in Malaysia

Koh HP, Ambaras Khan R, Tay SL, Gill MK, Wong JY, Zainuddin MK

Int J Clin Pharm, 2021 Oct;43(5):1337-1344.
PMID: 33677792 DOI: 10.1007/s11096-021-01255-w

Background Appropriate antimicrobial prescribing in the emergency department (ED) is a challenge due to diagnostic uncertainty, time pressure, and clinical inertia. Objective To assess the appropriateness of antimicrobial prescribing in the ED. Setting This study was conducted in the inpatient ED of a tertiary hospital in Malaysia. Method We conducted a 6-month retrospective antimicrobial prescriptions analysis among ED patients who received intravenous antimicrobial. Antimicrobial prescriptions of conveniently selected adult patients were evaluated with the medication appropriateness index. Main outcome measure Appropriateness of antimicrobial prescribing was the primary outcome measure. Results We analysed 310 patients with 326 antimicrobial prescriptions. Ceftriaxone (41.1%, n = 134) and amoxicillin-clavulanate (36.5%, n = 119) were the most common antimicrobials prescribed. Respiratory infections (71.5%, n = 233) was the main indication for antimicrobial therapy in the ED. All antimicrobials prescribed were indicated as per the Malaysian antimicrobial guidelines. The overall rate of inappropriate antimicrobial prescribing was 53.1% (n = 173). Thirty-two (9.8%) antimicrobials were prescribed with inappropriate doses; the majority was related to beta-lactam/beta-lactamase dose (p = 0.002). One hundred and forty-three (43.9%) antimicrobials prescribed had alternatives with similar efficacy but were less costly; which referring to ceftriaxone usage (p
Fulltext SELAMAT: A New Secure and Lightweight Multi-Factor Authentication Scheme for Cross-Platform Industrial IoT Systems

Khalid H, Hashim SJ, Ahmad SMS, Hashim F, Chaudhary MA

Sensors (Basel), 2021 Feb 18;21(4).
PMID: 33670675 DOI: 10.3390/s21041428

The development of the industrial Internet of Things (IIoT) promotes the integration of the cross-platform systems in fog computing, which enable users to obtain access to multiple application located in different geographical locations. Fog users at the network's edge communicate with many fog servers in different fogs and newly joined servers that they had never contacted before. This communication complexity brings enormous security challenges and potential vulnerability to malicious threats. The attacker may replace the edge device with a fake one and authenticate it as a legitimate device. Therefore, to prevent unauthorized users from accessing fog servers, we propose a new secure and lightweight multi-factor authentication scheme for cross-platform IoT systems (SELAMAT). The proposed scheme extends the Kerberos workflow and utilizes the AES-ECC algorithm for efficient encryption keys management and secure communication between the edge nodes and fog node servers to establish secure mutual authentication. The scheme was tested for its security analysis using the formal security verification under the widely accepted AVISPA tool. We proved our scheme using Burrows Abdi Needham's logic (BAN logic) to prove secure mutual authentication. The results show that the SELAMAT scheme provides better security, functionality, communication, and computation cost than the existing schemes.
Fulltext Tibia vara in Asians: Myth or fact? Verification with three-dimensional computed tomography

Ho JPY, Merican AM, Ayob KA, Sulaiman SH, Hashim MS

J Orthop Surg (Hong Kong), 2021 2 27;29(1):2309499021992618.
PMID: 33632009 DOI: 10.1177/2309499021992618

BACKGROUND: There is a common perception among surgeons that Asian tibiae are significantly more varus compared to non-Asians, contributed both by an acute medial tibial proximal angle (MPTA) and diaphyseal bowing. Insight into the normative morphology of the tibia allows generation of knowledge towards disease processes and subsequently planning for corrective surgeries.
METHODS: Computed tomography (CT) scans of 100 normal adult knees, aged 18 years and above, were analysed using a 3-dimensional (3D) analysis software. All tibiae were first aligned to a standard frame of reference and then rotationally aligned to the tibial centroid axis (TCAx) and the transmalleolar axis (tmAx). MPTA was measured from best-fit planes on the surface of the proximal tibia for each rotational alignment. Diaphyseal bowing was assessed by dividing the shaft to three equal portions and establishing the angle between the proximal and distal segments.
RESULTS: The mean MPTA was 87.0° ± 2.2° (mean ± SD) when rotationally aligned to TCAx and 91.6° ± 2.7° when aligned to tmAx. The mean diaphyseal bowing was 0.1° ± 1.9° varus when rotationally aligned to TCAx and 0.3° ± 1.6° valgus when aligned to tmAx. The mean difference when the MPTA was measured with two different rotational alignments (TCAx and tmAx) was 4.6° ± 2.3°. No statistically significant differences were observed between males and females. Post hoc tests revealed statistically significant difference in MPTA between different ethnic sub-groups.
CONCLUSION: The morphology of the proximal tibiae in the disease-free Asian knee is inherently varus but not more so than other reported populations. The varus profile is contributed by the MPTA, with negligible diaphyseal bowing. These implications are relevant to surgical planning and prosthesis design.
Fulltext Is Misdiagnosis of Type 1 Diabetes Mellitus in Malaysian Children a Common Phenomenon?

Mavinkurve M, Jalaludin MY, Chan EWL, Noordin M, Samingan N, Leong A, et al.

Front Endocrinol (Lausanne), 2021;12:606018.
PMID: 33763028 DOI: 10.3389/fendo.2021.606018

Background: Children with Type 1 diabetes (T1DM) commonly present in diabetic ketoacidosis (DKA) at initial diagnosis. This is likely due to several factors, one of which includes the propensity for T1DM to be misdiagnosed. The prevalence of misdiagnosis has been reported in non-Asian children with T1DM but not in Asian cohorts.
Aim: To report the rate of misdiagnosis and its associated risk factors in Malaysian children and adolescents with T1DM.
Methods: A retrospective analysis of children with T1DM below 18 years of age over a 10 year period was conducted.
Results: The cohort included 119 children (53.8% female) with a mean age 8.1 SD ± 3.9 years. 38.7% of cases were misdiagnosed, of which respiratory illnesses were the most common (37.0%) misdiagnosis. The rate of misdiagnosis remained the same over the 10 year period. Among the variables examined, younger age at presentation, DKA at presentation, healthcare professional (HCP) contact and admission to the intensive care unit were significantly different between the misdiagnosed and correctly diagnosed groups (p <0.05).
Conclusion: Misdiagnosis of T1DM occurs more frequently in Malaysian children <5 years of age. Misdiagnosed cases are at a higher risk of presenting in DKA with increased risk of ICU admission and more likely to have had prior HCP contact. Awareness of T1DM amongst healthcare professionals is crucial for early identification, prevention of DKA and reducing rates of misdiagnosis.
Fulltext An approach to develop clinical prediction rule for candidemia in critically ill patients: A retrospective observational study

Jameran AS, Cheah SK, Tzar MN, Musthafa QA, Low HJ, Maaya M, et al.

J Crit Care, 2021 10;65:216-220.
PMID: 34252648 DOI: 10.1016/j.jcrc.2021.06.018

PURPOSE: Early detection of candidemia in critically ill patients is important for preemptive antifungal treatment. Our study aimed to identify the independent risk factors for the development of a new candidemia prediction score.
METHODS: This single-centre retrospective observational study evaluated 2479 intensive care unit (ICU) cases from January 2016 to December 2018. A total of 76 identified candidemia cases and 76 matched control cases were analyzed. The patients' demographic characteristics and illness severity were analyzed, and possible risk factors for candidemia were investigated.
RESULTS: Multivariate logistic regression analysis identified renal replacement therapy (RRT) (odds ratio [OR]: 52.83; 95% confidence interval [CI]: 7.82-356.92; P < 0.0001), multifocal Candida colonization (OR: 23.55; 95% CI: 4.23-131.05; P < 0.0001), parenteral nutrition (PN) (OR: 63.67; 95% CI: 4.56-889.77; P = 0.002), and acute kidney injury (AKI) (OR: 7.67; 95% CI: 1.24-47.30; P = 0.028) as independent risk factors. A new prediction score with a cut-off value of 5.0 (80.3% sensitivity and 77.3% specificity) was formulated from the logit model equation.
CONCLUSIONS: Renal replacement therapy, AKI, PN, and multifocal Candida colonization were the independent risk factors for the new candidemia prediction score with high discriminatory performance and predictive accuracy.
Fulltext Rare late-presentation congenital diaphragmatic hernia mimicking a tension pneumothorax

Muien MZA, Jeyaprahasam K, Krisnan T, Ng CY, Teh YG

Radiol Case Rep, 2021 Sep;16(9):2542-2545.
PMID: 34276850 DOI: 10.1016/j.radcr.2021.06.024

Congenital Diaphragmatic Hernia (CDH) is due to a defect in the diaphragm and is usually detected soon after birth. However, in rare cases, asymptomatic CDHs can be missed and present later in life. Late-presentation CDH can be misdiagnosed as tension pneumothorax leading to iatrogenic complications. We report a case of a 10-year-old boy who presented with non-specific symptoms of vomiting and occasional breathlessness, but was subsequently diagnosed as late-presentation CDH. This case highlights the role of imaging in the diagnosis and management of late-presenting CDH. The role of CT imaging as an invaluable tool to further evaluate equivocal radiographic findings in CDH is discussed.
Fulltext Automatic segmentation of skin cells in multiphoton data using multi-stage merging

Prinke P, Haueisen J, Klee S, Rizqie MQ, Supriyanto E, König K, et al.

Sci Rep, 2021 07 15;11(1):14534.
PMID: 34267247 DOI: 10.1038/s41598-021-93682-y

We propose a novel automatic segmentation algorithm that separates the components of human skin cells from the rest of the tissue in fluorescence data of three-dimensional scans using non-invasive multiphoton tomography. The algorithm encompasses a multi-stage merging on preprocessed superpixel images to ensure independence from a single empirical global threshold. This leads to a high robustness of the segmentation considering the depth-dependent data characteristics, which include variable contrasts and cell sizes. The subsequent classification of cell cytoplasm and nuclei are based on a cell model described by a set of four features. Two novel features, a relationship between outer cell and inner nucleus (OCIN) and a stability index, were derived. The OCIN feature describes the topology of the model, while the stability index indicates segment quality in the multi-stage merging process. These two new features, combined with the local gradient magnitude and compactness, are used for the model-based fuzzy evaluation of the cell segments. We exemplify our approach on an image stack with 200 × 200 × 100 μm3, including the skin layers of the stratum spinosum and the stratum basale of a healthy volunteer. Our image processing pipeline contributes to the fully automated classification of human skin cells in multiphoton data and provides a basis for the detection of skin cancer using non-invasive optical biopsy.
Biomechanical analysis of three different types of fixators for anterior cruciate ligament reconstruction via finite element method: a patient-specific study

Zainal Abidin NA, Abdul Wahab AH, Abdul Rahim RA, Abdul Kadir MR, Ramlee MH

Med Biol Eng Comput, 2021 Sep;59(9):1945-1960.
PMID: 34392448 DOI: 10.1007/s11517-021-02419-6

Complication rates of anterior cruciate ligament reconstruction (ACL-R) were reported to be around 15% although it is a common arthroscopic procedure with good outcomes. Breakage and migration of fixators are still possible even months after surgery. A fixator with optimum stability can minimise those two complications. Factors that affect the stability of a fixator are its configuration, material, and design. Thus, this paper aims to analyse the biomechanical effects of different types of fixators (cross-pin, interference screw, and cortical button) towards the stability of the knee joint after ACL-R. In this study, finite element modelling and analyses of a knee joint attached with double semitendinosus graft and fixators were carried out. Mimics and 3-Matic softwares were used in the development of the knee joint models. Meanwhile, the graft and fixators were designed by using SolidWorks software. Once the meshes of all models were finished in 3-Matic, simulation of the configurations was done using MSC Marc Mentat software. A 100-N anterior tibial load was applied onto the tibia to simulate the anterior drawer test. Based on the findings, cross-pin was found to have optimum stability in terms of stress and strain at the femoral fixation site for better treatment of ACL-R.
Fulltext Developing a Risk Governance Framework on Radiological Emergency, Preparedness, and Response for Emergency Responders: Protocol for a Mixed Methods Study

Abd Rahman A, Abdul Manaf R, Lim PY, Suppiah S, Juni MH

JMIR Res Protoc, 2021 Aug 13;10(8):e25877.
PMID: 34398793 DOI: 10.2196/25877

BACKGROUND: Risk governance involves processes and mechanisms to understand how risk decisions are taken and executed. This concept has gained a reputation over time as being essential for emerging comprehensive management that defines the success of an organization. While guiding documents that explain the use of risk management related to nuclear safety and security are available worldwide, few locally conducted studies have explained risk governance practices in areas where hazard usage is known, such as in radiological emergencies.
OBJECTIVE: This paper describes a protocol that was used to determine several factors that influence emergency responders' perceptions toward radiological risk practices and visualize the risk radiological framework for emergency preparedness and response.
METHODS: A mixed methods study with a convergent design was performed. A qualitative analysis was performed using a case study approach where 6 key informants were purposely sampled for in-depth interview, and a cross-sectional study involving a self-administered questionnaire was conducted among approximately 260 emergency respondents from national regulatory, research, and services organizations. NVivo (version 12, QSR International) was used to analyze the interview transcripts and emerging themes were identified through abductive coding. Simultaneously, multiple logistic regression analysis was used to determine significant predictors that form the equation model.
RESULTS: The study is still underway. Qualitative findings were based on transcript-coding that informed the relevant thematic analysis, while statistical analyses including multiple logistic regression analysis measured the adjusted odds ratio of significant variables for the equation model. The study is expected to conclude in late 2021.
CONCLUSIONS: Important emerging themes and significant factors that are related to the emergency responders' perceptions regarding radiological governance practices were determined through the convergent design. This potentially facilitated the development of a plausible radiological risk governance framework. Furthermore, our results will provide key insights that can be used in future studies.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/25877.
Fulltext Prevalence of glycemic variability and factors associated with the glycemic arrays among end-stage kidney disease patients on chronic hemodialysis

Yusof Khan AHK, Zakaria NF, Zainal Abidin MA, Kamaruddin NA

Medicine (Baltimore), 2021 Jul 30;100(30):e26729.
PMID: 34397709 DOI: 10.1097/MD.0000000000026729

Glycemic variability (GV) confers a significantly higher risk of diabetic-related complications, especially cardiovascular. Despite extensive research in this area, data on end-stage kidney disease (ESKD) patients on chronic hemodialysis are scarce. This study aims to determine the magnitude of GV among ESKD (diabetic vs nondiabetic) patients and its associated factors on hemodialysis days (HDD) and non-hemodialysis days (NHDD) where postulation of a higher GV observed among diabetic on HDD.We recruited 150 patients on hemodialysis, 93 patients with type 2 diabetic (DM-ESKD), and 57 with nondiabetic (NDM-ESKD). The GV indices (standard deviation [SD] and percentage coefficient variant [%CV]) were obtained from 11-point and 7-point self-monitoring blood glucose (fasting to post-meal) (SMBG) profiles on HDD and NHDD. The GV indices and its associated factors of both DM-ESKD and NDM-ESKD were analyzed to compare HDD vs NHDD.Mean blood glucose on HDD was 9.33 [SD 2.7, %CV 30.6%] mmol/L in DM-ESKD compared with 6.07 [SD 0.85, %CV 21.3%] mmol/L in NDM-ESKD (P =
In vitro dissolution testing models of ocular implants for posterior segment drug delivery

Adrianto MF, Annuryanti F, Wilson CG, Sheshala R, Thakur RRS

Drug Deliv Transl Res, 2021 Aug 11.
PMID: 34382178 DOI: 10.1007/s13346-021-01043-z

The delivery of drugs to the posterior segment of the eye remains a tremendously difficult task. Prolonged treatment in conventional intravitreal therapy requires injections that are administered frequently due to the rapid clearance of the drug molecules. As an alternative, intraocular implants can offer drug release for long-term therapy. However, one of the several challenges in developing intraocular implants is selecting an appropriate in vitro dissolution testing model. In order to determine the efficacy of ocular implants in drug release, multiple in vitro test models were emerging. While these in vitro models may be used to analyse drug release profiles, the findings may not predict in vivo retinal drug exposure as this is influenced by metabolic and physiological factors. This review considers various types of in vitro test methods used to test drug release of ocular implants. Importantly, it discusses the challenges and factors that must be considered in the development and testing of the implants in an in vitro setup.
Composition of the essential oils of three Malaysian Xylopia species (Annonaceae)

Shakri NM, Salleh WMNHW, Khamis S, Mohamad Ali NA, Nadri MH

Z Naturforsch C J Biosci, 2020 Nov 26;75(11-12):479-484.
PMID: 32960782 DOI: 10.1515/znc-2020-0096

The rich and diversified Malaysian flora represents an excellent resource of new chemical structures with biological activities. The genus Xylopia L. includes aromatic plants that have both nutritional and medicinal uses. This study aims to contribute with information about the volatile components of three Xylopia species essential oils: Xylopia frutescens, Xylopia ferruginea, and Xylopia magna. In this study, essential oils were extracted from the leaves by a hydrodistillation process. The identification of the essential oil components was performed by gas chromatography (GC-FID) and gas chromatography-coupled mass spectrometry (GC-MS). The major components of the essential oils from X. frutescens were bicyclogermacrene (22.8%), germacrene D (14.2%), elemol (12.8%), and guaiol (12.8%), whereas components of the essential oils from X. magna were germacrene D (35.9%), bicyclogermacrene (22.8%), and spathulenol (11.1%). The X. ferruginea oil was dominated by bicyclogermacrene (23.6%), elemol (13.7%), guaiol (13.4%), and germacrene D (12.3%).
Fulltext Wilms tumor presenting as small bowel obstruction in a neonate: A diagnostic challenge

Ahmed S, Nadarajan C, Ng CY, Teh YG, Abdul Muien MZ, Liew CSL

Radiol Case Rep, 2021 Oct;16(10):2908-2912.
PMID: 34401023 DOI: 10.1016/j.radcr.2021.06.058

Wilms tumor is the most common primary malignant renal tumor of childhood which usually presents between 2 and 6 years of age. Its presentation in the neonatal period is extremely rare and presenting with intestinal obstruction is perhaps unknown. We report a 2-day-old baby girl who manifested features of acute upper gastrointestinal obstruction with frequent post-feeding vomiting and abdominal distension. The initial abdominal radiograph showed abnormally displayed small bowel loops to the right hemiabdomen. Subsequent ultrasound and computed tomography scan of the abdomen detected a massive left renal mass. Left-sided nephrectomy was performed, and histopathology demonstrated left-sided Wilms tumor with favorable histology. Post-treatment yearly follow-up for 5 years recorded a disease-free, normally thriving child.
Determination of Phenolics and Flavonoids of Some Useful Medicinal Plants and Bioassay-Guided Fractionation Substances of Sclerocarya birrea (A. Rich) Hochst Stem (Bark) Extract and Their Efficacy Against Salmonella typhi

Abdallah MS, Mustafa M, Nallappan MA, Choi S, Paik JH, Rusea G

Front Chem, 2021;9:670530.
PMID: 34386478 DOI: 10.3389/fchem.2021.670530

Gallic acid and catechin are the most abundant phenolic and flavonoid contents found in all plant extracts. The contents and the bioassay-guided fractionating substances of the Sclerocarya birrea (A. Rich) Hochst (Anacardiaceae) fraction played vital roles. The goals of the study were to determine the contents of some useful medicinal plants and the bioassay-guided fractionation substances of S. birrea fraction compounds capable of acting against Salmonella isolate using LC-MS/LC-HRMS (Dionex ultimate 3000 RS UPLC with Thermo Scientific Q Exactive Orbitrap Hybrid Tandem Mass Spectrometer). The Folin-Ciocalteu reagent procedure and flavonoid content determination were conducted spectrophotometrically. Bioassay-guided fractionation, chronological partitioning, and screening of the antibacterial action against Salmonella typhi were performed. The ethyl acetate fraction extracts of S. birrea stem (bark) extract were analyzed using LC-MS/LC-HRMS. The gallic acid content increased tremendously in Vachellia nilotica (L.) P.J.H. Hurter and Mabb (Fabaceae) pod extracts with curve fitting (R 2 = 0.9958). Catechin content increase was significantly increased in S. birrea stem (bark) extracts followed by that of V. nilotica pod extracts with curve fitting (R 2 = 0.9993); they were all significantly different in the Guiera senegalensis J.F. Gmel. and the Leptadenia lanceolata (Poir.) Goyder leaves extracts at p value <0.0001. Subsequently, 10 mg/ml of S. birrea stem (bark) ethyl acetate fraction extract was the MIC, where no MBC was recorded and susceptible to the positive control with the highest inhibition zone, followed by the ethyl acetate fraction extract at 10 mg/ml (9.7 ± 0.0) at Turkey's p < 0.0001. Vidarabine is one of the novel compounds, specifically having antimicrobial actions, found in the S. birrea stem (bark). Reasonable amounts of phenolic and flavonoid contents determined the actions of the individual plant extract.
Fulltext Angle-insensitive co-polarized metamaterial absorber based on equivalent circuit analysis for dual band WiFi applications

Hannan S, Islam MT, Faruque MRI, Chowdhury MEH, Musharavati F

Sci Rep, 2021 Jul 02;11(1):13791.
PMID: 34215833 DOI: 10.1038/s41598-021-93322-5

A novel and systematic procedure to design a co-polarized electromagnetic metamaterial (MM) absorber with desired outputs and resonance frequencies for dual-band WiFi signal absorption is presented. The desired resonance frequencies with expected S parameters' values were first designed as an equivalent circuit with extensive analysis and then implemented into frequency-selective MM absorber by numerical simulation with precise LRC elements, satisfying least unit cell area (0.08λ), substrate thickness (0.01λ) and maximum effective medium ratio (12.49). The absorber was simulated for the maximum angle of incidence for both the normal and oblique incidences at co-polarization. The absorptions at the desired resonance frequencies were found at a satisfactory level by both simulation and practical measurement along with a single negative value to ensure metamaterial characteristics. The proposed equivalent circuit analysis approach can help researchers design and engineering co-polarization insensitive MM absorbers using conventional split-ring resonators, with perfection in output and desired resonance frequencies without the necessity of lumped elements or multilayer substrates. The proposed metamaterial can be utilized for SAR reduction, crowdsensing, and other WiFi-related practical applications.
Fulltext Testing role of green financing on climate change mitigation: Evidences from G7 and E7 countries

Wu X, Sadiq M, Chien F, Ngo QT, Nguyen AT, Trinh TT

Environ Sci Pollut Res Int, 2021 Dec;28(47):66736-66750.
PMID: 34235703 DOI: 10.1007/s11356-021-15023-w

The study estimates the long-run dynamics of a cleaner environment in promoting the gross domestic product of E7 and G7 countries. The recent study intends to estimate the climate change mitigation factor for a cleaner environment with the GDP of E7 countries and G7 countries from 2010 to 2018. For long-run estimation, second-generation panel data techniques including augmented Dickey-Fuller (ADF), Phillip-Peron technique and fully modified ordinary least square (FMOLS) techniques are applied to draw the long-run inference. The results of the study are robust with VECM technique. The outcomes of the study revealed that climate change mitigation indicators significantly affect the GDP of G7 countries than that of E7 countries. The GDP of both E7 and G7 countries is found depleting due to less clean environment. However, green financing techniques helps to clean the environment and reinforce the confidence of policymakers on the elevation of green economic growth in G7 and E7 countries. Furthermore, study results shown that a 1% rise in green financing index improves the environmental quality by 0.375% in G7 countries, while it purifies 0.3920% environment in E7 countries. There is a need to reduce environmental pollution, shift energy generation sources towards alternative, innovative and green sources.The study also provides different policy implications for the stakeholders guiding to actively promote financial hedging for green financing. So that climate change and envoirnmental pollution reduction could be achieved effectively. The novelty of the study lies in study framework.
Endometrioma Presented as Acute Abdomen in a Peritoneal Dialysis Patient: A Case Report and Literature Review

Ahmad ZA, Ramly F, Mohd Zahid AZ, Abdullah B, Abdul Hafidz MI

Int J Womens Health, 2021;13:639-644.
PMID: 34234575 DOI: 10.2147/IJWH.S304818

Laparoscopic management in patients on peritoneal dialysis offers good postoperative outcome and early resumption to peritoneal dialysis. This is a report of a 43-year-old woman with end-stage kidney disease on peritoneal dialysis presented with left iliac fossa pain due to a large endometrioma. Emergency diagnostic laparoscopy was performed with careful laparoscopic entry, Tenckhoff catheter care and anti-adhesive application. The patient underwent temporary hemodialysis for two weeks before full resumption to peritoneal dialysis. She was planned for GnRH analogue for three months post-operatively. In conclusion, laparoscopy is a safe and advantageous route of surgery for ovarian endometrioma in patients on peritoneal dialysis. However, mindful surgical strategies are needed to ensure the Tenckhoff catheter's longevity and early resumption to peritoneal dialysis post-operatively.
Fulltext An overview of procurement, pricing, and uptake of COVID-19 vaccines in Pakistan

Siddiqui A, Ahmed A, Tanveer M, Saqlain M, Kow CS, Hasan SS

Vaccine, 2021 08 31;39(37):5251-5253.
PMID: 34364719 DOI: 10.1016/j.vaccine.2021.07.072
Development of biodegradable thin films for efficient, specific and controlled delivery of capecitabine

Gul I, Yunus U, Ajmal M, Bhatti MH, Chaudhry GE

Biomed Mater, 2021 Aug 31;16(5).
PMID: 34375958 DOI: 10.1088/1748-605X/ac1c61

Cancer is the leading cause of death worldwide. Capecitabine (CP) shows severe side effects because of early metabolism in stomach that affects the normal cells and organs, particularly liver and stomach. In this scope, we report the biocompatible, nontoxic polymeric thin films loaded with anti-cancer drug, CP for target specific, sublingual delivery of CP. Chitosan (CS) and polyvinyl alcohol (PVA) were used as biodegradable polymers alongwith glutaraldehyde (GLA) cross linker. CP-loaded thin films (TFCP1-TFCP5) were fabricated by solvent casting method. The results of Fourier transform infrared spectroscopy confirmed the presence of CP and polymers (CS and PVA) with GLA which binds through hydrogen bonding, and compatibility of drug with different excipients. Thermogravemetric analysis showed that the thin films are highly stable while differential scanning calorimeter thermograms confirmed the complete miscibility/entrapment of CP within PVA/CS thin film matrix. X-ray diffraction patterns revealed the molecular ineractions between CP and polymer matrix. High degree of swelling index of thin films at pH 7.4 was observed in comparison to pH 5.5. CP release studies in acetate (pH 5.5) and phosphate buffer (pH 7.4) showed that the thin films swell and result in drug diffusion faster in phosphate buffer through diffusion governed by Higuchi's model. Cytotoxicity results displayed that CPTFs killed MCF-7 and T47D (human breast adenocarcinoma) cells more effectively as compared to CP alone. The results of adhesion assay also showed that the PVA and CS both are safe and biocompatible. TFCP1 and TFCP3 thin films efficiently induced the apoptosis as compared to CP alone. The improved ability of TFCP1 and TFCP3 to induce cytotoxicity in MCF-7 cells reflects the potential of these thin films for targeted drug delivery. The CPTFs were stable for 4 months at 4 °C/60% ± 2%RH and 25 °C/70% ± 2%RH. In conclusion, the thin film formulations showed target specific controlled and burst release properties and thus could prove to be effective for human breast cancer treatment.

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