Search

Background: Healthcare professionals are required to work effectively together to deliver the best healthcare services. Without awareness of other healthcare professionals’ roles and responsibilities, interprofessional practice (IPP) cannot be optimally achieved. Objectives: This study aimed to investigate healthcare professionals’ awareness of audiology and speech-language pathology (SLP) services in Saudi Arabia. Method: This cross-sectional descriptive study consisted of two parts. The content of a 20-item paper questionnaire was firstly validated. The full-scale study addressed the aim through distributing questionnaire items among potential participants. Descriptive statistics and chi-square test were used. Results: A total of 403 participants completed the questionnaires for the main study. Most of the participants were Saudi citizens (84.1%), aged 18 years – 40 years (84.8%) years, and lived in Riyadh region (76.2%). Allied health professionals (40.2%), physicians (22.6%), nursing (15.4%) and dentistry (11.2%) were the main group of participants working mainly at governmental hospitals (69.2%). Of the total participants, 92.6% and 95.3% reported being fully aware of the services provided by audiologists and SLPs, respectively. No statistically significant association between the specialty of participants and their familiarity with the scope of practice for SLPs and audiologists was determined. Conclusion: Our study examined healthcare professionals’ awareness of audiology and SLP services and revealed a high level of awareness. Contribution: The existed level of awareness is expected to facilitate IPP and enhance the quality of care. Still, awareness campaigns about audiology and SLP services are needed to address the existing lack of knowledge among some healthcare professionals.

Asif Ali Safeer,1 Iqbal Hussain,2 Muhammad Abrar,2 Rizwan Shabbir2 1Business School, Huanggang Normal University, Huanggang, People’s Republic of China; 2Lyallpur Business School, Government College University Faisalabad PakistanCorrespondence: Rizwan Shabbir, Jinnah Block, Lyallpur Business School, Government College University, Faisalabad, Pakistan, Email rizwanshabbir@gcuf.edu.pkPurpose: Retail businesses have been seeing dramatic changes in the last decades. It has evolved from single-channel retailing to omnichannel retailing, providing a seamless shopping experience to customers. Customers armed with modern technology are creating challenges for retailers and forcing them to create an omnichannel environment. So, implementing an omnichannel retailing strategy is a big challenge for retail managers in the age of modern technologies. Retailers could evaluate consumers’ usage intention of omnichannel retailing based on technological and psychological factors. However, research based on psychological factors is limited in the prevailing literature on omnichannel retailing. Based on the Motivational Model (MM) and Big-Five Factors (BFF) of personality traits, the study tried to fill the gap regarding the influence of psychological factors on omnichannel usage intention.Methods: A sample of 724 respondents through a structured questionnaire from a developing economy. The target population of the current study was internet users, as they might be prospective Omni shoppers in the near future. Relationships were tested through Structural Equation Modeling (SEM) with AMOS 23.Results: Results revealed that personality traits directly correlate with omnichannel usage intention, while motivations (intrinsic and extrinsic) partially mediate these relationships. Moreover, the results of the current study also revealed that the personality traits extraversion, agreeableness, and conscientiousness are vital antecedents of behavioral intention. Intrinsic and extrinsic motivations positively impact consumers’ usage intention, while extrinsic motivation partially mediates intrinsic motivation and consumers’ usage intention. Additionally, full mediation prevails in the association of consumers’ usage intention and personality traits (emotional stability and Openness to experiences).Originality: The domino effects provide a solid theoretical milestone in understanding the phenomenon of omnichannel retailing strategy and facilitates marketing managers to design channel strategies for emerging economics.Keywords: omnichannel retailing, big-five personality traits, extrinsic motivation, intrinsic motivation, usage intention

Depletion of fossil fuel and pollution by heavy metals are two major global issues. The cell wall of algae consists of polymers of polysaccharides such as cellulose, hemicellulose, alginate, starch, and many others that are readily hydrolyzed to monosaccharides and hence are amenable to fermentation into bioethanol. Moreover, algae contain lipids that may undergo trans-esterification to biodiesel, and can be absorbed by heavy metals. In this study, extraction of lipids from Turbinaria turbinata (common brown alga) from the beach of Sharma, NEOM, Tabuk, Saudi Arabia by different solvents hexane, methanol, and hexane: methanol (1:1), and trans-esterification was performed to obtain biodiesel and investigated by GC.MS. The alga residue after fats extractions by different solvents was used in bioremediation synthetic wastewater containing 50 ppm of As−3, Co+2, Cu+2, Fe+2, Mn+2, and Zn+2. The residue of defatted alga was hydrolyzed by 2% H2SO4 and then fermented to obtain bioethanol. The combination of hexane: methanol (1:1) gave the greatest amount of petroleum hydrocarbons, which contain Tetradecane, 5-methyl, Octacosane, Pentatriacontane, and a small amount of Cyclotrisiloxane, Hexamethyl. The most effective removal % was obtained with alga residue defatted by hexane: methanol (1:1), and methanol, 100% removal of As−3, 83% Co+2, 95% Cu+2, 97.25% Fe+2, Mn+2 79.69%, Zn+2 90.15% with 2 g alga /L at 3 hours. The lowest value of sugar was obtained with hexane: methanol residue but gave the highest bioethanol efficiency. Thus, it is possible to use Turbinaria turbinata, or brown alga as a feedstock to produce bio-diesel, and bioethanol, and to remove heavy metals from wastewater, which may have a great economic and environmental significance.

BACKGROUND: The 30-day period following emergency colorectal surgery (ECRS) is associated with high mortality and morbidity. There is a lack of data assessing factors associated with outcomes of ECRS in the Saudi population. OBJECTIVES: Assess factors associated with 30-day postoperative mortality and complications following ECRS DESIGN: Retrospective cohort study SETTING: Single tertiary care center, Riyadh, Saudi Arabia PATIENTS AND METHODS: Demographic characteristics (age, sex, diagnosis, American Society of Anesthesiologists classification, pre-operative septic state, smoking, and comorbidities), operative characteristics (urgency, diverting ostomy, and procedure performed), and postoperative characteristics (length of stay, 30-day mortality, intensive care unit [ICU] admission, ICU length of stay, surgical site infection [SSI], readmission, reoperation, and complications) were collected from electronic medical records. Univariate logistic regression was used to evaluate association with the outcome measures (30-day mortality and postoperative complications). Multivariate logistic regression was applied to evaluate independent variables. MAIN OUTCOME MEASURE: Thirty-day postoperative mortality and morbidity SAMPLE SIZE: 241 patients RESULTS: Among 241 patients, 145 (60.2%) were men, and 80 (33.2%) patients were between 50–64 years of age. The most common indication for surgery was malignancy 138 (57%). The overall complication rate was 26.6% and the 30-day mortality rate was 11.2%. Left hemicolectomy was the most commonly performed procedure, performed in 69 (28.6%) patients. Patients between the age of 65–74 had an increased odds of death within 30 days (OR 5.25 [95% CI 1.03–26.5]) on univariate analysis. Preoperative sepsis was associated with a fourfold increase in the likelihood of 30-day mortality (OR 4.44, 95% CI 1.21–16.24, P=.024) on multivariate analysis. The likelihood of hospital re-admission increased by fivefold in patients who developed a postoperative complication (OR 5.33, 95% CI 1.30–21.78, P=.02). CONCLUSION: Preoperative sepsis was independently associated with 30-day mortality in patients undergoing ECRS, while the likelihood of hospital readmission increased in patients with postoperative complications. Expeditious control of sepsis in the emergency surgical setting by both surgical and medical interventions may reduce the likelihood of postoperative mortality. Establishing discharge protocols for postoperative ECRS patients is advocated. LIMITATIONS: Retrospective design, small sample size, and single setting

Objective: This study aims to describe the characteristics and outcomes of burn injuries in pediatric and adult patients admitted to Ministry of National Guard Health Affairs (MNGHA) hospitals in Saudi Arabia. Methods: A multicenter retrospective cohort study was conducted between 2015 and 2021 in five hospitals run by the MNGHA in Saudi Arabia. The study included 555 patients who were admitted to the hospital with burns, and data were collected from an institutional trauma registry on various aspects such as sociodemographic variables, burn clinical characteristics and burn outcomes. The differences in epidemiological data, general characteristics, and outcomes of burn patients with ≤18 and >18 years of age among Saudi hospitalized patients. The associations between patient characteristics and burn outcomes were assessed using multivariable logistic regression. Results: Most of the participants representing 66.1% males and females 33.9%. Flame and contact were the most common causes of burn injuries, accounting for 43.6% and 43.2% of cases, respectively; followed by chemical (6.7%), then electrical (5.4%), and friction (1.1%). The study revealed that pediatric were the most frequently admitted age group for burn injuries with most cases occurring at home (57%). Pediatric patients had a higher percentage of hot fluid injuries, accounting for 77.5 % of cases (P = 0.00). Flame injuries were more prevalent in adults, accounting for 65.3% of cases (P

In an attempt to reduce such decay induced by pathogenic causes, several studies investigated the effectiveness of nanoparticles (NPs) that play a vital role in saving food products, especially fruits. Current research delves into biogenic silver nanoparticles (using marine alga Turbinaria turbinata (Tt/Ag-NPs) and their characterization using FT-IR, TEM, EDS, and zeta potential. Some pathogenic fungi, which cause fruit spoilage, were isolated. We studied the impact of using Tt/Ag-NPs to protect against isolated fungi in vitro, and the influence of Tt/Ag-NPs as a coating of tomato fruit to protect against blue mold caused by Penicillium italicum (OR770486) over 17 days of storage time. Five treatments were examined: T1, healthy fruits were used as the positive control; T2, healthy fruits sprayed with Tt/Ag-NPs; T3, fruits infected with P. italicum followed by coating with Tt/Ag-NPs (pre-coating); T4, fruits coated with Tt/Ag-NPs followed by infection by P. italicum (post-coating); and T5, the negative control, fruits infected by P. italicum. The results displayed that Tt/Ag-NPs are crystalline, spherical in shape, with size ranges between 14.5 and 39.85 nm, and negative charges. Different concentrations of Tt/Ag-NPs possessed antifungal activities against Botrytis cinerea, Rhodotorula mucilaginosa, Penicillium expansum, Alternaria alternate, and Stemphylium vesicarium. After two days of tomatoes being infected with P. italicum, 55% of the fruits were spoilage. The tomato fruit coated with Tt/Ag-NPs delayed weight loss, increased titratable acidity (TA%), antioxidant%, and polyphenol contents, and decreased pH and total soluble solids (TSSs). There were no significant results between pre-coating and post-coating except in phenol contents increased in pre-coating. A particular focus is placed on the novel and promising approach of utilizing nanoparticles to combat foodborne pathogens and preserve commodities, with a spotlight on the application of nanoparticles in safeguarding tomatoes from decay.

Bariatric surgery (BS) is associated with vitamin and mineral deficiencies, which might be augmented by low adherence to dietary guidelines and inappropriate dietary behaviours. The aim of this study was to determine the influence of BS on eating behaviour, prevalence of nutrient deficiency, level of commitment to diet, and lifestyle recommendations one-year post-BS.A cross-sectional study was conducted among adult patients who underwent BS in 2019 and had follow-up for a year. Age, gender, and clinical data were collected from the hospital system and other information was obtained from questionnaires during phone interviews. A total of 160 patients participated in the study.At 12 months, a significant increase from the baseline values in plasma levels of vitamin B12, folate, vitamin D, iron, corrected calcium, albumin, CRP, and MCV, as well as a significant decrease in BMI was observed. Adherence to dietary and lifestyle recommendations was moderate to high. Emotional, and restrained eating behaviours were moderate with 64.4%, and 77.5%, respectively. External eating was low at 58.1%.The study concluded that pre-and post-bariatric surgery nutrients should be closely monitored.

Background: The goal of the present research was to employ CBCT imaging to assess the root and canal anatomy of maxillary second molars in a population from the Hail province of Saudi. The effects of gender and side were taken into account. Methods: The investigation included a sample size of 499 completely developed right and left untreated maxillary second molars obtained from 250 Saudi people. The root morphology of each tooth was evaluated. The examination also included an analysis of the canal morphology for each tooth, utilizing Vertucci's categorization. The effect of genders as well as sides was recorded. Results were analyzed using the Chi-square test. Results: 464 teeth had three roots (93.0%), whereas 20 teeth (4.0%) had two roots. One root was recorded in 7 (1.4%) of the study sample, whilst 8 (1.6%) had four roots. Although there were no significant differences between the left and right sides (p = .075), gender had a significant influence on the number of roots (p = .030). 240 M (48.1%) had three canal orifices, and 247 (49.5%) had four root canal orifices. Eight molars (1.6%) had two canal orifices, while one and five canal orifices were found in 3 (0.6%) and one (0.2%), respectively. Gender had a significant impact on the number of root canal orifices (p = .039). The observed differences in the orifices of the root canals between the left and right sides were not statistically significant (p = .059). The prevalence of MB2 in maxillary second molars was found to be 49.7%. In the mesiobuccal root, the Vertucci type I configuration had the highest canal frequency (50.3%), followed by the Vertucci types II (14.4%), IV (13.8%), V (12.0%), and III (7.6%), and VI (1.8%). The prevalence of Vertucci type I canal configurations was found to be higher in the distobuccal root (99.4%) and palatal root (98.2%) of maxillary second molars. Conclusions: Significant variations in root canal anatomy were observed within the Saudi population. The majority of the subjects from Saudi Arabia in this study exhibited the presence of maxillary second molars with three roots. Approximately half of the sample under investigation exhibited the presence of the four canals.

There are two major problems in the world, fuel deficiency and environmental pollution by fossil fuels. Microalgae are regarded as one of the most feasible feedstocks for the manufacturing of biofuels and are used in the degradation of fossil fuel spills. The present study was possessed to investigate the ability of green alga Chlorella vulgaris, blue-green alga Synechococcus sp, and its consortium to grow and degrade hydrocarbon such as kerosene (k) with different concentrations (0, 0.5, 1, and 1,5%), and also using algal biomasses to produce biofuel. The algal growth was estimated by optical density (O.D) at 600 nm, pigment contents such as Chlorophyll a,b carotenoid, and dry weight. The kerosene degradation was estimated by FT-IR analysis after and before the cultivation of algae and its consortium. The components of the methanol extract were determined by GC-MS spectroscopy. The results denote the best growth was determined by O.D, algae consortium with 1.5% Kerosene after ten days, meanwhile, the highest dry weight was with C. vulgaris after ten days of cultivation. The FT-IR demonstrated the algae and consortium possessed high efficacy to degrade kerosene. After 15 days of algae cultivation with 1% K, C.vulgaris produced the maximum amount of lipids (32%). The GC-MS profile of methanol extract of two algae and consortium demonstrated that Undecane was presented in high amounts, C.vulgaris (19.9%), Synechococcus sp (82.16%), algae consortium (79.51%), and also were presented moderate amounts of fatty acid methyl ester in Synechococcus sp. Overall, our results indicate that a consortium of algae can absorb and remove kerosene from water, and at the same time produce biofuels like biodiesel and petroleum-based fuels.

This quantitative observational cross-sectional study assessed the prevalence and level of risk scores for varicose veins among nurses, and the association between varicose veins and sociodemographic, occupational, and lifestyle risk factors. Using simple random sampling, from August–December 2022, 250 nurses from different departments at King Khalid University Hospital completed a validated self-administered questionnaire and underwent an observational physical examination. Most nurses (191) had low-risk scores for varicose veins, 46 nurses had moderate-risk scores, and 13 nurses had high-risk scores. From the outpatient clinics, 61.5% of nurses had significant high-risk scores for varicose veins. Those with a statistically significant association had a family history of varicose veins (p < 0.001) and other chronic medical conditions (p = 0.04). Physical activity, especially race-walking/running (p = 0.006), showed a statistically significant association with the varicose veins score. The years as a staff nurse were statistically significant among the occupational risk factors (p = 0.003). The adjusted multivariable regression model showed three significant predictors: a positive family history, running/walking, and total years as a staff nurse (p < 0.001, p = 0.02, and p < 0.001, respectively). Nurses working at outpatient clinics, positive family history, years as a staff nurse, and other chronic conditions are risk factors for varicose veins, while race-walking/running is a protective factor.

BackgroundThe lockdown at the start of coronavirus disease 2019 (COVID-19) pandemic in Saudi Arabia (March 2020 to June 2020) shifted routine in-person care for patients with type 2 diabetes mellitus (T2DM) to telemedicine. The aim of this study was to investigate the impact telemedicine had during this period on glycemic control (HbA1c) in patients with T2DMMethods4,266 patients with T2DM were screened from five Ministry of National Guard Health Affairs hospitals in the Kingdom of Saudi Arabia. Age, gender, body mass index (BMI), HbA1c (before and after the COVID-19 lockdown), duration of T2DM, comorbidities and antidiabetic medications data were obtained. Mean and standard deviation of differences in HbA1c were calculated to assess the impact of telemedicine intervention. Correlations between clinically significant variances (when change in the level is ≥0.5%) in HbA1c with demographics and clinical characteristic data were determined using chi square test.ResultsMost of the participants were Saudis (97.7%) with 59.7% female and 56.4% ≥60 years of age. Obesity was 63.8%, dyslipidemia 91%, and hypertension 70%. Mean HbA1c of all patients slightly rose from 8.52% ± 1.5% before lockdown to 8.68% ± 1.6% after lockdown. There were n=1,064 patients (24.9%) whose HbA1c decreased by ≥0.5%, n =1,574 patients whose HbA1c increased by ≥0.5% (36.9%), and n =1,628 patients whose HbA1c changed by

Cerebral Palsy (CP) is an umbrella name for disorders caused by abnormal brain development or damage to the developing brain. It affects the child's ability to move and maintain balance and posture. CP is the most common cause of motor disability in childhood. CP has various classification systems based on body structure and function, such as the topographic classification into quadriplegia, diplegia, and hemiplegia, or based on activities such as the gross motor function classification system (GMFCS). Classifying children with CP is challenging for clinicians due to the homogeneous nature of the clinical presentations of children with CP. Classifications of CP can guide the planning of services that enhance the quality of life of children and their families. There are a few studies about children with CP in Jordan. Data about children with CP in Jordan are also lacking. This study, therefore, aims to compile a comprehensive, concise, and fully annotated national dataset for Jordanian children with CP and to provide a benchmark for related studies in the field of pediatric rehabilitation medicine (PRM). This work presents the methodology implemented to compile and analyze the dataset and the experiments conducted on this dataset. We evaluated the dataset using a set of five commonly used machine learning classification algorithms, namely, K-Star, Multilayer Perceptron (MLP), Naïve Bayes (NB), Random Tree (RT), and Support Vector Machine (SVM). The MLP classifier successfully classified CP-type cases with an accuracy rate of 84% and GMFCS cases with an accuracy rate of 53%. The obtained results were promising and encouraging to put the compiled CP dataset into practice for clinicians, researchers, and policymakers working in the field of PRM.

Evidence from the literature suggests an association between the microbiome and asthma development. Here, we aimed to identify the current evidence for the association between asthma and the upper airway, lower airway and/or the gut microbiome. An electronic systemic search of PubMed, EBSCO, Science Direct and Web of Science was conducted until February 2022 to identify the eligible studies. The Newcastle–Ottawa Scale and the Systematic Review Centre for Laboratory Animal Experimentation risk of the bias tools were used to assess quality of included studies. Twenty-five studies met the inclusion criteria. Proteobacteria and Firmicutes were identified as being significantly higher in the asthmatic children compared with the healthy controls. The high relative abundance of Veillonella, Prevotella and Haemophilus in the microbiome of the upper airway in early infancy was associated with a higher risk of asthma development later in life. The gut microbiome analyses indicated that a high relative abundance of Clostridium in early childhood might be associated with asthma development later in life. The findings reported here serve as potential microbiome signatures associated with the increased risk of asthma development. There is a need for large longitudinal studies to further identify high-risk infants, which will help in design strategies and prevention mechanisms to avoid asthma early in life.

Background: Dentists have a vital role in detection of the signs and symptoms of obstructive sleep apnea (OSA) as it modifies in anatomy of orofacial structures. Aims and Objectives: This study aims to assess the prevalence of OSA risk in patients attending dental department and explore the factors related with high-risk OSA. Materials and Methods: The study was carried in the Al-Farabi Dental College, Jeddah, Saudi Arabia, on 200 consecutive dental patients from June 1, 2018, to July 31, 2019. Demographic details and the OSA risk were evaluated based on the Berlin questionnaire (Arabic version). Two qualified investigators independently did anthropometric measurements, medical and dental examination. Results: About 3.7% of males and 13.8% of females were found to be at high risk of OSA. Obese individuals almost had twice more likely chance to have OSA symptoms. Conclusion: Our findings confirm that dentists have an important role in recognizing the OSA signs and symptoms.

Quality of life (QoL) is essential for maintaining a healthy, balanced lifestyle, especially among individuals with chronic diseases. Saudi Arabia (SA) launched a health sector transformation program as part of the nationwide Vision 2030 initiative to ensure the sustainable development of efficient healthcare services, aiming to improve health by increasing well-being and QoL. More investigation into the current status of health rehabilitation services provided to individuals with chronic diseases and future needs to optimize services and improve QoL is needed. This was narratively discussed by experts from different health rehabilitation services in SA. Comprehensive health rehabilitation services including orthopedic, occupational, cardiac, pulmonary, critical care, perioperative, hearing and speech, substance use disorders, and vocational rehabilitation services were addressed. Health rehabilitation services in SA, as in other countries, are suboptimal for individuals in health rehabilitation programs. To optimize the QoL of individuals with chronic diseases, health rehabilitation services should be tailored based on the unique requirements of each service and its serving patients. The shared need to improve health rehabilitation services includes the adoption of home-based and telehealth services, the integration of multi-governmental sectors, the empowerment and allocation of health rehabilitation specialists, public awareness campaigns, policy legislation and guideline development, and the implementation of a long-term follow-up system. This review is one of the first to address the intersection of health rehabilitation services and QoL in SA; urgent and holistic actions are paramount to address the pressing need to optimize SA’s health rehabilitation services. The experts’ recommendations in this study may be applicable to other countries’ health systems, as health rehabilitation services are not well optimized globally.

Mohsin Bashir,1 Muhammad Abrar,1 Muhammad Yousaf,2 Shahnawaz Saqib,1 Rizwan Shabbir1 1Faculty of Economics and Management Sciences, Lyallpur Business School, Government College University, Faisalabad, Pakistan; 2Rahim Yar Khan Division, MEPCO, Punjab, PakistanCorrespondence: Shahnawaz SaqibLyallpur Business School, Faculty of Economics and Management Sciences, Government College University, 1st Floor, Jinnah Block, Lyallpur Business School, Government College University, New Campus, Jhang Road, Faisalabad, PakistanTel +92 300 670 4501Email shahnawaz_saqib@yahoo.comBackground: Politics and political behaviors are a vicious and bitter reality in an organization’s life. Although under investigation for more than three decades, the literature lacks sufficient studies investigating culture-specific potential factors which have the potency to moderate the poisonous consequences of organizational politics. The aim of this study was to investigate the relationship of organizational politics and deviance in unionized settings with the moderating role of resilience in unionized employees in higher power distance culture.Methods: A cross-sectional design was followed for data collection. The population of this study was low-ranked employees having union identity and working in the largest power distribution company of Pakistan. Stratified sampling was applied, and eight strata’s were considered on the basis of geographical distribution, a total of 400 questionnaires were distributed among the employees of eight circles, fifty from each. Smart PLS.3.2.0 was used to analyze data through Structural Equation Modeling (SEM) under measurement and structural models.Conclusion: From a theoretical perspective, this study confirmed that employees tend to show interpersonal deviance when they experience organizational politics, but organizational politics does not promote organizational deviance. Under stress, the individual also shows a slightly higher level of interpersonal deviance as compared to organizational deviance. However, the moderating role of resilience has not been proved in this study. Research limitations and future directions have also been discussed.Keywords: organizational politics, interpersonal deviance, organizational deviance, job stress, resilience, lower-level employees

Nitrate-rich food increases nitric oxide (NO) production and may have beneficial effects on vascular, metabolic, and brain function. This pilot study tested the effects of prolonged consumption of a range of doses of dietary nitrate (NO3−), provided as beetroot juice, on cognitive function and cerebral blood flow (CBF) in overweight and obese older participants. The study had a 13-week single-blind, randomised, parallel design, and 62 overweight and obese older participants (aged 60 to 75 years) received the following interventions: (1) high NO3− (2 × 70 mL beetroot juice/day) (2) medium NO3− (70 mL beetroot juice/day), (3) low NO3− (70 mL beetroot juice on alternate days), or (4) placebo (70 mL of NO3−-depleted beetroot juice on alternate days). Cognitive functions were assessed using the Computerised Mental Performance Assessment System (COMPASS) assessment battery. CBF, monitored by concentration changes in oxygenated and deoxygenated haemoglobin, was assessed in the frontal cortex using near-infrared spectroscopy. The findings of this pilot study showed that cognitive function and CBF were not affected by supplementation with NO3−-rich beetroot juice for 13 weeks, irrespective of the NO3− dose administered. These findings require confirmation in larger studies using more sophisticated imaging methods (i.e., MRI) to determine whether prolonged dietary NO3− supplementation influences brain function in older overweight people.

Background: Nitrate-rich food can increase NO production and may induce positive effects on brain function. This study examined the feasibility of a randomized clinical trial (RCT) testing the effects of prolonged consumption of incremental doses of dietary nitrate (NO3−) in overweight and obese older participants. Secondary aims tested dose-dependent changes in cognitive, vascular and pulmonary functions and cerebral blood flow (CBF). Methods: This was a single blind, four-arm parallel RCT conducted in 60 overweight and obese older participants. Eligible participants were randomized to:1) high NO3− (140 ml of beetroot juice (BJ) per day, ~800 mg of NO3−/day), 2) moderate NO3− (70 ml of BJ per day, ~400 mg of NO3−/day), 3) low NO3− (70 ml on alternate days, ~400 mg of NO3−) or 4) NO3− depleted (70 ml on alternate days, ~0.001 mg of NO3). Measurements of cognitive, vascular and pulmonary functions and CBF were conducted at baseline and 13-weeks NO3− intake was assessed by six 24-h recalls, and by measuring NO3− intake biomarkers. Feasibility was assessed by obtaining qualitative feedback and evaluating trial recruitment, retention, compliance with study visits and measurement protocols. Results: Participant recruitment started in July 2018 and ended in April 2019. Of all the recruitment strategies that were used, advertisement of the study via Facebook generated the highest response rate. Sixty-two participants consented and were enrolled. Overall, characteristics of included participants matched our recruitment criteria. Conclusion: The findings from this study provide evidence of the acceptability and feasibility of an intervention investigating the effects of incremental doses of high-nitrate BJ over a prolonged period. Trial registration: The intervention study was registered with clinical trial ISRCTN registry (ISRCTN14746723) on 27 December 2018.

Objectives: The combination of 2 chemotherapeutic agents has been recommended in order to reduce their adverse side effects and potentiate their efficacy. The aim of the present study was to assess the antineoplastic activity of doxorubicin (DOX) combined with gemcitabine (GEM) in nanoemulsion (NE) against various cancer cells and to examine their adverse effects on the healthy human foreskin (HFS) cells. Materials and Methods: The physical characterizations of the drug-loaded NE formulations were determined by Zetasizer. The cytotoxicity of the drugs was evaluated by the thiazolyl blue tetrazolium bromide (MTT) assay while the mechanism of cell death was examined by light microscopy, nuclear staining with 4′,6-diamidino-2-phenylindole (DAPI) and ApopNexin FITC apoptosis detection kit. Results: The Zetasizer results demonstrated that the nanoparticle of the combination of 5 μM of DOX and GEM in NE (5DOX/5GEM-NE) has a particle size of 155.38 ± 3.08 nm with a polydispersity index of 0.02 ± 0.28 and a negative zeta potential of -7.70 ± 1.30 mV. The 5DOX/5GEM-NE has decreased the percentages of HeLa cervical cancer cell viabilities to 27.00 ±5.62%, but it has not considerably changed the percentages of HFS cell viabilities (97.06 ± 6.09%) when compared to the single treatments of DOX and GEM. According to the mechanism of cell death studies, 5DOX/5GEM-NE has induced apoptosis in HeLa cells without affecting the HFS cells. Conclusions: The present study proved that formulating DOX and GEM in NE has ameliorated the efficacy of DOX and GEM as anticancer drugs while reducing their adverse effects on the healthy cells.

Nitrate-rich food can increase nitric oxide production and improve vascular and brain functions. This study examines the feasibility of a randomised controlled trial (RCT) testing the effects of prolonged consumption of different doses of dietary nitrate (NO3−) in the form of beetroot juice (BJ) in overweight and obese older participants. A single-blind, four-arm parallel pilot RCT was conducted in 62 overweight and obese (30.4 ± 4 kg/m2) older participants (mean ± standard deviation (SD), 66 ± 4 years). Participants were randomized to: (1) high-NO3− (HN: 2 × 70 mL BJ/day) (2) medium-NO3− (MN: 70 mL BJ/day), (3) low-NO3− (LN: 70 mL BJ on alternate days) or (4) Placebo (PL: 70 mL of NO3−-depleted BJ on alternate days), for 13 weeks. Compliance was checked by a daily log of consumed BJ, NO3− intake, and by measuring NO3− and NO2− concentrations in plasma, saliva, and urine samples. Fifty participants completed the study. Self-reported compliance to the interventions was >90%. There were significant positive linear relationships between NO3− dose and the increase in plasma and urinary NO3− concentration (R2 = 0.71, p < 0.001 and R2 = 0.46 p < 0.001, respectively), but relationships between NO3− dose and changes in salivary NO3− and NO2− were non-linear (R2 = 0.35, p = 0.002 and R2 = 0.23, p = 0.007, respectively). The results confirm the feasibility of prolonged BJ supplementation in older overweight and obese adults.