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• There is increasing concern regarding waning immunity against SARS-CoV-2, breakthrough infections and immune-evasive variants. • Heterologous prime-boost strategies are gaining attention due to theoretical superiority of immune stimulation, supply shortage and adverse event concerns with certain vaccine platforms. • More robust humoral response was observed in the heterologous BNT-boosted group compared to the homologous BBIBP primed and boosted group. • Significantly greater levels of spike (S) protein specific antibodies were observed in the heterologous group compared to the homologous one. • The heterologous BNT-boosted group had a higher rate of non-serious adverse events, all of which were self-limiting, indicating it to be a safe and well-tolerated approach. Booster vaccine doses against SARS-CoV-2 have been advocated to address evidence of waning immunity, breakthrough infection, and the emergence of immune-evasive variants. A heterologous prime-boost vaccine strategy may offer advantages over a homologous approach, but the safety and efficacy of this approach with the mRNA vaccine BNT162b2 (BNT: Pfizer) and inactivated BBIBP-CorV (BBIBT: Sinopharm) vaccines have not been studied. We conducted a non-randomized, non-blinded phase II observational community trial across Bahrain, investigating the reactogenic and immunogenic response of participants who had previously received two doses of BBIBP, followed by a third booster dose of either BBIBP (homologous booster) or BNT (heterologous booster). Immunogenicity through serological status was determined at baseline and on the following 8th week. Reactogenicity data (safety and adverse events) were collected throughout study period, in addition to participant-led electronic journaling. 305 participants (152 BBIBP and 153 BNT booster) were enrolled in the study, with 246 (127 BBIBP and 119 BNT booster) included in the final analysis. There was a significant increase in anti-SARS-CoV-2 antibody levels post booster administration in both groups; however, the heterologous BNT arm demonstrated a significantly larger mean increase in the level of spike (S) antigen-specific antibodies (32.7-fold increase versus 2.6, p < 0.0001) and sVNT neutralising antibodies (3.4-fold increase versus 1.8, p < 0.0001), whereas the homologous arm demonstrated a significant increase in the levels of nucleocapsid (N) antigen-specific antibodies (3.8-fold increase versus none). Non-serious adverse events (injection site pain, fever, and fatigue) were more commonly reported in the heterologous arm, but no serious adverse events occurred. Heterologous prime-boost vaccination with the mRNA BNT162b2 (Pfizer) vaccine in those who had received two doses of inactivated virus BBIBP-CorV (Sinopharm) vaccine demonstrated a more robust immune response against SARS-CoV-2 than the homologous BBIBP booster and appears safe and well tolerated. Clinical Trial Registry Number (ClinicalTrials.gov): NCT04993560. [ABSTRACT FROM AUTHOR]

Culinary spices and herbs, renowned for their flavor, aroma, and medicinal properties, contain essential nutrients but also may pose health concerns due to heavy metal contamination. This systematic review, in accordance with PRISMA guidelines, investigates the global concentrations of heavy metals in culinary spices and herbs, and evaluates associated health risks. Fifty peer-reviewed studies from Scopus, PubMed, and Web of Science were examined and findings revealed variations in heavy metal content based on country of origin and spice type. In the MENA region, caraway and green cardamom from Bahrain had high levels of Pb (2.2 μg/g) and Cd (0.9 μg/g). Indian spices like cloves and Ajwain seeds exhibited high levels of iron (17.87 ± 8 mg/kg) and calcium (1353 ± 10 mg/kg). African and European spices showed regional disparities, with some exceeding permissible Pb and Cd limits. Non-carcinogenic human health risk assessments via oral exposure pathway conducted on reported Cd, Ni, and Cu concentrations throughout the reviewed global studies revealed no risks across all regions and for all spices and herbs under study except in Turkey for Cd levels found in chamomile with hazard quotients ranging between 1.26 and 1.47. On the other hand, carcinogenic risks varied based on reported Pb concentrations, ranging from 8.5 × 10−8 to a maximum of 4.96 × 10−3. These findings underscore the need for global vigilance in food safety practices and future research in countries with less stringent policies. Recommendations include improved agricultural practices, enhanced soil management, and stringent post-harvest procedures to mitigate contamination. [Display omitted] • Spices and herbs show diverse metal content, requiring safety monitoring. • Most spices and herbs are non-carcinogenic, few exhibited carcinogenic risks. • Studies recommend stringent controls to mitigate heavy metal contamination. • Review significant in future research directions and measures for spice safety. [ABSTRACT FROM AUTHOR]

Yemen witnesses a heinous war and continual conflict that devastates its fragile infrastructure. The country's development indicators devolve significantly, and, among other sectors, higher education and its quality have been imperiled. The objective of this paper is to explore the effects of war on the quality of higher education in Yemen from the standpoint of Yemeni scholars. This qualitative study is based on grounded theory design and used semi-structured in-depth interview methods to collect data from Yemeni scholars within and outside Yemen. The core questions focused on the impact of war, the actions taken by scholars, and the prospects of higher education quality. Seventeen diverse scholars were included in the study. The analysis of data outlined six war-related factors that affect the quality of higher education: attacks on scholars, financial constraints, corruption, human capacity shortage, poor research performance, and lack of physical capacity. Realities are reconstructed through descriptions of the trajectory of the war and its negative consequences on scholars and their endeavors. Quality as a sign of the good functioning of higher education institutions is not an exclusively sectorial issue. Actions and prospects need to fit within frameworks of national reconciliation, regional peace, and frameworks of international cooperation. Further research tackling other dimensions of education quality and including other stakeholders is needed. Rethinking and reforming Yemen's higher education system in its different aspects and challenges, are paths to peacebuilding and the recovery of the country. A roadmap prioritizing this reform is urgently needed. • The devastating effects of war were examined from the perspective of Yemeni scholars. • The endurance of scholars to cope with the situation was exposed, analyzed, and compared with other countries in the region. • A prospect for national, regional, and international actions was suggested. [ABSTRACT FROM AUTHOR]

How does progesterone improve fetal outcome and change the expression of placental glucose transporters (GLUT) in dexamethasone-induced intrauterine growth restriction (IUGR)? A total of 64 rats were divided randomly into four different treatment groups based on daily i.p. injections of either saline or dexamethasone in the presence or absence of progesterone. Injections started on the 15th day of gestation (15dg) and lasted until the day of sacrifice at 19dg or 21dg. Maternal plasma progesterone concentrations were measured by enzyme-linked immunosorbent assay. The gene and protein expression of placental GLUT1 and GLUT3 were evaluated in the placental labyrinth and basal zones by real-time polymerase chain reaction and Western blotting, respectively. The localization of GLUT1 and GLUT3 was evaluated by immunohistochemistry. Dexamethasone induced significant decreases in maternal serum progesterone concentrations (P = 0.029) and placental (P < 0.001) and fetal body (P = 0.009) weights. Dexamethasone also reduced the expression of GLUT1 in the labyrinth zone (P = 0.028) and GLUT3 in both the labyrinth (P = 0.002) and basal zones (P = 0.026). Coadministration of dexamethasone and progesterone prevented the reduction in fetal body weight, placental weight and placental GLUT expression compared with that seen in dexamethasone-treated groups. These results suggest that progesterone prevents the significant reduction in fetal and placental weights in dexamethasone-induced IUGR, possibly through improving the expression of placental GLUT. [ABSTRACT FROM AUTHOR]

Microbial fuel cell (MFC) is a promising technology for simultaneous wastewater treatment and energy harvesting. The properties of the anode material play a critical role in the performance of the MFC. In this study, graphene oxide was prepared by a modified hummer's method. A thin layer of graphene oxide was incorporated on the carbon brush using an electrophoretic technique. The deoxygenated graphene oxide formed on the surface of the carbon brush (RGO-CB) was investigated as a bio-anode in MFC operated with real wastewater. The performance of the MFC using the RGO-CB was compared with that using plain carbon brush anode (PCB). Results showed that electrophoretic deposition of graphene oxide on the surface of carbon brush significantly enhanced the performance of the MFC, where the power density increased more than 10 times (from 33 mWm−2 to 381 mWm−2). Although the COD removal was nearly similar for the two MFCs, i.e., with PCB and RGO-CB; the columbic efficiency significantly increased in the case of RGO-CB anode. The improved performance in the case of the modified electrode was related to the role of the graphene in improving the electron transfer from the microorganism to the anode surface, as confirmed from the electrochemical impedance spectroscopy measurements. Image 1 • Graphene electrodeposited on the carbon brush (G-CB). • The G-CB has no effect on both COD removal and biofilm. • The graphene layer improved the extracellular electron transfer. • The G-CB enhanced the MFC performance and Coulombic efficiency. [ABSTRACT FROM AUTHOR]

Heterozygous pathogenic WAC variants cause Desanto-Shinawi syndrome; affected patients have dysmorphic features, developmental impairment and behavioral abnormalities. Seizures are reported in one quarter, including tonic-clonic, absence, and febrile seizures. This study aimed to better understand the phenotypic spectrum of epilepsy and development in Desanto-Shinawi syndrome. We identified four children with seizures and pathogenic WAC variants, including two siblings. All had global developmental impairment with language affected most severely; two had diagnoses of childhood apraxia of speech and two had autism spectrum disorder. Seizure onset age ranged from six months to 14 years. Seizures always occurred from sleep and were focal impaired awareness with motor features in three patients, with one having bilateral tonic-clonic seizures of suspected focal onset. Two patients had spontaneous seizure resolution without treatment, and the remaining two were well-controlled on monotherapy. EEG was normal in two patients; one had focal right frontal spikes in drowsiness and sleep while the last had independent centrotemporal spikes from both hemispheres, activated in sleep. All patients had heterozygous truncating pathogenic WAC variants, with negative parental testing. The findings in this cohort of patients suggest that epilepsy in Desanto-Shinawi syndrome is usually focal and self-limited, and may fall within the epilepsy-aphasia spectrum. • Four children with heterozygous WAC pathogenic variants and epilepsy are described. • All children had global developmental impairment with language most severely affected. • Two children had childhood apraxia of speech and 2 had autism spectrum disorder. • Seizures were self-limited in 2, and controlled on monotherapy in the other 2. • Seizures were typically focal from sleep; onset age ranged from 6 months to 14 years. [ABSTRACT FROM AUTHOR]

Current demands for flexible services based on context-aware applications are mounting. The efficiency of such services mainly depends on acquiring, organizing, accessing, processing and sharing the user's context. This context usage yield to more concerns and even more worries about the user's data privacy. Hence, in this work we propose a privacy-aware method to address users privacy protection concerns in context-aware environments through automated decision-making processes by monitoring their privacy behavior and personal data usage. [ABSTRACT FROM AUTHOR]

Surface-enhanced Raman spectroscopy offers great potential for rapid and highly sensitive detection of pharmaceuticals from environmental sources. Herein, we investigated the feasibility of label-free sensing of antibiotic residues from wastewater effluents with high specificity by combining with multivariate analysis. Highly ordered silver nanoarrays with ∼34 nm roughness have been fabricated using a cost-effective electroless deposition technique. As-fabricated Ag arrays showed superior LSPR effects with an enhancement factor of 8 × 107. Excellent reproducibility has also been noticed with RSD values within 11%, whilst the sensor showed good stability and reusability characteristics for being used as a low-cost and reusable sensor. SERS studies demonstrated that antibiotics-spiked wastewater effluents can be detected with high efficiency in a label-free method. The molecular fingerprint bands of antibiotics such as sulfamethoxazole, sulfadiazine, and ciprofloxacin were well analyzed in effluent, tap, and deionized water. It has been found that antibiotics can be detected near picomolar levels; meanwhile, liquid chromatography-mass spectrometry (LC-MS) exhibited a detection limit within nanomolar concentrations only. Furthermore, the specificity of SERS sensing has been further analyzed using a multivariate analysis method, principal component analysis followed by linear discriminant analysis (PCA-LDA); which showed prominent discrimination to distinguish each antibiotic residue from wastewater effluents. The current study presented the potential of Ag nanoarray sensors for rapid, highly specific, and cost-effective analysis of pharmaceutical products for environmental remediation applications. [Display omitted] • High-performance Ag nanoarrays were facile fabricated for SERS sensing. • Excellent efficiency, reproducibility and reusability were established. • Rapid, label-free sensing of antibiotics including SMX, SDZ and CPX was investigated. • Picomolar detection limit was established for antibiotics spiked wastewater effluents. • Multivariate analysis revealed the high specificity of direct SERS sensing. [ABSTRACT FROM AUTHOR]

Use and up-titration of guideline directed medical therapy (GDMT) remains an issue nationwide. CHAMP-HF database and US PINNACLE registry data suggest that approximately one-third and one-fourth of patients are not on an angiotensin converting enzyme inhibitor/angiotensin receptor blocker or beta blocker, respectively. A similar problem is seen with the underutilization of mineralocorticoid receptor antagonists (MRAs) and angiotensin II receptor blocker neprilysin inhibitors (ARNIs). The utilization rate of these agents in the US PINNACLE registry was 8.5%. Per the American College of Cardiology Consensus Document, full GDMT up-titration can be achieved in biweekly intervals and completed in 3-6 months. Our study aims to look at a single hospital patient population with heart failure with reduced ejection fraction to assess whether different GDMT titration intervals of < 3 months, 3-6 months, 6-9 months or > 9 months incurred any differences in safety in terms of changes in post-titration systolic blood pressure (SBP), diastolic blood pressure (DBP), estimated glomerular filtration rate (eGFR), as well as admissions for heart failure up to a year from the start of GDMT titration. There will be no difference in mean systolic and diastolic blood pressure, eGFR or number of heart failure admissions between the different titration groups. A retrospective chart review was completed between January and December of 2021 to assess the number of patients who had completed titration of GDMT. Patients were stratified into different times to full GDMT titration groups of < 3 months, 3-6 months, 6-9 months and > 9 months. Data for blood pressure and eGFR before and after completion of GDMT titration, as well as the total number of heart failure admissions 1 year after the start of titration was recorded. Mean differences in SBP, DBP and eGFR were calculated, and a One-Way ANOVA test was used to compare means between the four titration groups. Mean differences in SBP and DBP increased the longer the time to titration, however, the results are not statistically significant (P value 0.47 and 0.21, respectively). Changes in eGFR varied amongst groups and were not statistically different. Mean heart failure hospitalizations per patient across all groups was close to 0 with a slight increase in admissions with longer titration periods but, this was not statistically significant. There was no statistically significant difference in mean systolic and diastolic blood pressures, eGFR, or mean number of heart failure hospitalizations per patient among different titration groups. [ABSTRACT FROM AUTHOR]

• This trial showed no difference in postoperative oedema and pain amongst the splint and no-splint groups in surgically treated ankle fractures. • There is no difference in the functional outcome, however, early satisfaction scores were higher in the no-splint group. • The splint group had a significantly higher rate of emergency department visits and a high rate of splint-related complications. There is considerable variation in the rehabilitation of ankle fractures. Ankle fractures treated surgically are often immobilized or splinted in the early post-operative period, despite the lack of robust evidence supporting this intervention. Thus, this randomized controlled trial aims to investigate the anecdote that splinting reduces pain and oedema. A prospective multi-centre randomized controlled trial was performed in three trauma centres. Eligible patients were over 18 years of age that have sustained an isolated unilateral ankle fracture requiring surgical intervention. Patients were randomized to two groups receiving either; a plaster of Paris posterior back-slab or compressive bandage dressing. The post-operative rehabilitation protocol was standardized across both groups. Baseline demographics and fracture characteristics and classifications were analysed. Primary outcomes included; oedema measured by the figure-of-eight-20 technique and pain at multiple time points. Secondary outcomes included; the American Orthopaedic Foot and Ankle Society (AOFAS) score, satisfaction, unplanned emergency room (ER) visits and complications. A total of 104 comparable participants were included; 54 in the non-splint group and 50 in the splint group. There was no significance difference in ankle oedema, ankle oedema compared to contralateral ankle and pain scores between the two groups (P = 0.56, P = 0.25, P = 0.39 respectively). Patient satisfaction was higher in the early postoperative period in the non-splint group (P = 0.016). The AOFAS score was not significantly different across any time point (P = 0.534). In the splint group, there was a 46% rate of splint-related complaints and complications. Unplanned ER visits occurred in 46% of the splint group and 7.4% of the non-splint group (P < 0.001). There were 2 wound infections, 1 non-union and 1 deep vein thrombosis in the splint group. There was 1 wound infection and 1 deep vein thrombosis in the no-splint group (P = 0.481) The routine use of a splint does not add any perceivable benefit to the postoperative course of an ankle fracture fixation, particularly in the reduction of oedema and postoperative pain. Another key finding is that the absence of a splint does not appear to result in higher complication rates, instead leads to higher unplanned ER visits and lower early satisfaction rates. [ABSTRACT FROM AUTHOR]