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Soil electrokinetics (SEK) research has been widely used in various fields such as soil remediation, dewatering, land restoration, geophysics, sedimentation, pollution prevention, consolidation, and seed germination. According to our most recent published research on SEK process design modifications during the last 30 years (1993–2022), more than 150 designs have been introduced to assure SEK’s maximum performance. Incorporating lateral electrodes/anodes was not documented in the existing literature, which motivated us to investigate the output of this design. In this study, we aimed to enhance the performance of the perforated cathode pipe soil electrokinetic remediation (SEKR) system (PCPSS) for removing inorganic pollutants by installing lateral anodes (LA-PCPSS) using two approaches. In the first approach, the LA-PCPSS was connected to different sources of applied voltages (DSAV) from different power supplies, while in the second approach, the entire operation system was connected to the same source of applied voltage (SSAV). We used the Taguchi approach (L 9 OA) to determine the optimal levels of applied voltages for the DSAV system. The results indicated that the DSAV-(LA-PCPSS) could be optimized at an applied voltage of 1 V cm −1 for the surface and the first and second lateral anodes. The indigenous Sr (elements found in the tested soil without artificial pollution) in kaolinite showed the best response among other elements (Ni and other indigenous elements) when optimizing the DSAV-(LA-PCPSS) using the Taguchi approach. Installing lateral anodes (position B) supplied to low applied voltage (0.5 V cm −1 ) improved the electroosmosis (EO) rate/dewatering. Reverse migration of ions was observed during the remediation of real contaminated soil using the SSAV-(LA-PCPSS). The DSAV-(LA-PCPSS) is considered an appropriate design for the SEKR of inorganic pollutants, and increases the EO flow/dewatering. Additionally, the increased energy consumption employing the DSAV-(LA-PCPSS) was extremely minimal compared to the traditional PCPSS, which is an economic advantage for SEKR research. The DSAV-(LA-PCPSS) is still under optimization/intensification process, and subsequent processes will be examined to achieve high efficiency.

An innovative approach to ticks and insect pests management is necessary to mitigate the challenges posed by the indiscriminate use of chemical pesticides, which can lead to resistance development and environmental pollution. Despite their great potential, biological control agents have significant manufacturing, application, and stability limitations. Currently, using phytochemicals, biosynthesized nanoparticles, and bioagents to get rid of arthropods might be a good alternative that would make farmers less worried about residues and resistance. The present investigation was carried out to determine for the first time the in vitro acaricidal and insecticidal efficacies of endogenous two entomopathogenic nematodes (EPNs), Heterorhabditis indica and Steinernema sp. combined with either Proteus mirabilis -synthesized silver nanoparticles or Rosmarinus officinalis essential oil against the camel tick, Hyalomma dromedarii larvae and females, and greater wax moth, Galleria mellonella larvae as well. We also determined the potential effects of these treatments on the biological characteristics of H. dromedarii ’s engorged females. We further investigated R. officinalis essential oil (EO) profiling and nanoparticle (AgNPs) characterization. All the evaluated combinations demonstrated synergistic effects on the larvae of G. mellonella and H. dromedarii , as well as on engorged females. When H. indica was mixed with EO or AgNPs, it worked well than when Steinernema sp. was mixed with EO or AgNPs. This was shown by the highest number of tick and insect mortalities and the lowest lethal concentration (LC 50 ) values. One day after G. mellonella was exposed to H. indica (1,000 infective juveniles (IJs)) together with EO at 60 or 40 mg/mL, all tested individuals died. We obtained the same results when H. dromedarii females exposed to the same level of EPN with 60 mg/mL EO, and when H. dromedarii larvae treated with H. indica at 500 IJs + EO at 25 mg/mL. Treatments altered all biological parameters of engorged females, revealing extremely noticeable differences between the treated and untreated groups. Gas chromatography–mass spectrometry (GC-MS) analysis identified a total of 28 compounds in the R. officinalis EO. Visual observation showed a color change from yellow to dark brown for AgNPs biosynthesized from P. mirabilis ; the transmission electron microscopy (TEM) image and ultraviolet–visible (UV-Vis) spectrum showed well-dispersed particles with a diameter of 5–45 nm; and the greatest surface plasmon peaked at 320 nm. The results demonstrated the high efficacy of combining EPN, H. indica , with EO to control tick and insect pests. This is due to its acaricidal activity on different stages of H. dromedarii , including larvae and engorged females, and its larvicidal effect on G. mellonella .

The chicken gut is the habitat to trillions of microorganisms that affect physiological functions and immune status through metabolic activities and host interaction. Gut microbiota research previously focused on inflammation; however, it is now clear that these microbial communities play an essential role in maintaining normal homeostatic conditions by regulating the immune system. In addition, the microbiota helps reduce and prevent pathogen colonization of the gut via the mechanism of competitive exclusion and the synthesis of bactericidal molecules. Under commercial conditions, newly hatched chicks have access to feed after 36–72 h of hatching due to the hatch window and routine hatchery practices. This delay adversely affects the potential inoculation of the healthy microbiota and impairs the development and maturation of muscle, the immune system, and the gastrointestinal tract (GIT). Modulating the gut microbiota has been proposed as a potential strategy for improving host health and productivity and avoiding undesirable effects on gut health and the immune system. Using early-life programming via in ovo stimulation with probiotics and prebiotics, it may be possible to avoid selected metabolic disorders, poor immunity, and pathogen resistance, which the broiler industry now faces due to commercial hatching and selection pressures imposed by an increasingly demanding market.

The whitefly, Bemisia tabaci, is the main pest for many field and horticultural crops, causing main and significant problems. The efficiency of imidacloprid insecticide as seed treatment and foliar spray at three rates against the whitefly, B. tabaci, was evaluated in tomato plants under field conditions; in addition, insecticide residues were determined in tomato leaves and fruits. The obtained results revealed that the seedlings produced from treated seeds with imidacloprid were the most effective treatment in decreasing whitefly stages. Reduction percentages of whitefly stages in seedlings produced from treated seeds and sprayed with ½, ¾ and 1 field rates of imidacloprid were more than that produced from untreated seeds. Tomato fruit yield in seedlings produced from treated seeds and sprayed with one recommended rate of imidacloprid was more than that of untreated seeds. The residues of imidacloprid in leaves and fruits in seedlings produced from treated seeds and sprayed with field rate were more than that of untreated seeds; additionally, the residues were higher in leaves than in fruits. The residual level in fruits was less than the maximum residual level (MRL = 1 mg kg−1) of the Codex Alimentarius Commission. The half-life (t ½) was 6.99 and 6.48 days for leaves and fruits of seedlings produced from treated seeds and 5.59 and 4.59 days for untreated seeds. Residues in tomato fruits were less than the MRL, therefore, imidacloprid is considered an unconventional insecticide appropriate for B. tabaci control that could be safe for the environment.

Background. Hereditary renal tubular disorders (HRTD) represent a group of genetic diseases characterized by disturbances in fluid, electrolyte, and acid-base homeostasis. There is a paucity of studies on pediatric HRTD in Egypt. In this study, we aimed to study the pattern, characteristics, and growth outcome of HRTD at an Egyptian medical center. Methods. This study included children from one month to < 18-years of age with HRTD who were diagnosed and followed up at the Pediatric Nephrology Unit of Sohag University Hospital from January 2015 to December 2021. Data on patients` demographics, clinical features, growth profiles, and laboratory characteristics were collected. Results. Fifty-eight children (57% males; 72% parental consanguinity; 60% positive family history) were diagnosed with seven HRTD types. The most commonly encountered disorders were distal renal tubular acidosis (distal renal tubular acidosis [RTA] 27 cases, 46.6%) and Bartter syndrome (16 cases 27.6%). Other identified disorders were Fanconi syndrome (6 cases with cystinosis), isolated proximal RTA (4 cases), nephrogenic diabetes insipidus (3 cases), and one case for each RTA type IV and Gitelman syndrome. The median age at diagnosis was 17 months with a variable diagnostic delay. The most common presenting features were failure to thrive (91.4%), developmental delay (79.3%), and dehydration episodes (72.4%). Most children showed marked improvement in growth parameters in response to appropriate management, except for cases with Fanconi syndrome. Last, only one case (with cystinosis) developed end-stage kidney disease. Conclusions. HRTD (most commonly distal RTA and Bartter syndrome) could be relatively common among Egyptian children, and the diagnosis seems challenging and often delayed.

Although patients with chronic kidney disease (CKD) are routinely managed in primary care settings, no nationally representative study has assessed the quality of care received by these patients in Canada. To evaluate the current state of CKD management in Canadian primary care practices to identify care gaps to guide development and implementation of national quality improvement initiatives. This cross-sectional study leveraged Canadian Primary Care Sentinel Surveillance Network data from January 1, 2010, to December 31, 2015, to develop a cohort of 46 162 patients with CKD managed in primary care practices. Data analysis was performed from August 8, 2018, to July 31, 2019. The study examined the proportion of patients with CKD who met a set of 12 quality indicators in 6 domains: (1) detection and recognition of CKD, (2) testing and monitoring of kidney function, (3) use of recommended medications, (4) monitoring after initiation of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), (5) management of blood pressure, and (6) monitoring for glycemic control in those with diabetes and CKD. The study also analyzed associations of divergence from these quality indicators. The cohort comprised 46 162 patients (mean [SD] age, 69.2 [14.0] years; 25 855 [56.0%] female) with stage 3 to 5 CKD. Only 4 of 12 quality indicators were met by 75% or more of the study cohort. These indicators were receipt of an outpatient serum creatinine test within 18 months after confirmation of CKD, receipt of blood pressure measurement at any time during follow-up, achieving a target blood pressure of 140/90 mm Hg or lower, and receiving a hemoglobin A1c test for monitoring diabetes during follow-up. Indicators in the domains of detection and recognition of CKD, testing and monitoring of kidney function (specifically, urine albumin to creatinine ratio testing), use of recommended medications, and appropriate monitoring after initiation of treatment with ACEIs or ARBs were not met. Only 6529 patients (18.4%) with CKD received a urine albumin test within 6 months of CKD diagnosis, and 3954 (39.4%) had a second measurement within 6 months of an abnormal baseline urine albumin level. Older age (≥85 years) and CKD stage 5 were significantly associated with not satisfying the criteria for the quality indicators across all domains. Across age categories, younger patients (aged 18-49 years) and older patients (≥75 years) were less likely to be tested for albuminuria (314 of 1689 patients aged 18-49 years [18.5%], 1983 of 11 919 patients aged 75-84 years [61.6%], and 614 of 5237 patients aged ≥85 years [11.7%] received the urine albumin to creatinine ratio test within 6 months of initial estimated glomerular filtration rate <60 mL/min per 1.73 m2; P < .001). Patients aged 18 to 49 years were less commonly prescribed recommended medications (222 of 2881 [7.7%]), whereas patients aged 75 to 84 years were prescribed ACEIs or ARBs most frequently (2328 of 5262 [44.2%]; P < .001). The findings suggest that management of CKD across primary care practices in Canada varies according to quality indicator. This study revealed potential priority areas for quality improvement initiatives in Canadian primary care practices.

IntroductionElectronic consultation (eConsult)—provider-to-provider electronic asynchronous exchanges of patient health information at a distance—is emerging as a potential tool to improve the interface between primary care providers and specialists. Despite growing evidence that eConsult has clinical benefits, it is not widely adopted. We investigated factors influencing the adoption and implementation of eConsult services.MethodsWe applied established methods to guide the review, and the recently published Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews to report our findings. We searched five electronic databases and the grey literature for relevant studies. Two reviewers independently screened titles and full texts to identify studies that reported barriers to and/or facilitators of eConsult (asynchronous (store-and-forward) use of telemedicine to exchange patient health information between two providers (primary and secondary) at a distance using secure infrastructure). We extracted data on study characteristics and key barriers and facilitators were analysed thematically and classified using the Quadruple Aim framework taxonomy. No date or language restrictions were applied.ResultsAmong the 2579 publications retrieved, 130 studies met eligibility for the review. We identified and summarised key barriers to and facilitators of eConsult adoption and implementation across four domains: provider, patient, healthcare system and cost. Key barriers were increased workload for providers, privacy concerns and insufficient reimbursement for providers. Main facilitators were remote residence location, timely responses from specialists, utilisation of referral coordinators, addressing medicolegal concerns and incentives for providers to use eConsult.ConclusionThere are multiple barriers to and facilitators of eConsult adoption across the domains of Quadruple Aim framework. Our findings will inform the development of practice tools to support the wider adoption and scalability of eConsult implementation.

Haemodialysis (HD) is the commonest form of kidney replacement therapy in the world, accounting for approximately 69% of all kidney replacement therapy and 89% of all dialysis. Over the last six decades since the inception of HD, dialysis technology and patient access to the therapy have advanced considerably, particularly in high-income countries. However, HD availability, accessibility, cost and outcomes vary widely across the world and, overall, the rates of impaired quality of life, morbidity and mortality are high. Cardiovascular disease affects more than two-thirds of people receiving HD, is the major cause of morbidity and accounts for almost 50% of mortality. In addition, patients on HD have high symptom loads and are often under considerable financial strain. Despite the many advances in HD technology and delivery systems that have been achieved since the treatment was first developed, poor outcomes among patients receiving HD remain a major public health concern. Understanding the epidemiology of HD outcomes, why they might vary across different populations and how they might be improved is therefore crucial, although this goal is hampered by the considerable heterogeneity in the monitoring and reporting of these outcomes across settings.This Review examines the epidemiology of haemodialysis outcomes — clinical, patient-reported and surrogate outcomes — across world regions and populations, including vulnerable individuals. The authors also discuss the current status of monitoring and reporting of haemodialysis outcomes and potential strategies for improvement.

ObjectiveTo describe the use of electronic health (eHealth) in support of health coverage for kidney care across International Society of Nephrology (ISN) regions.DesignSecondary analysis of WHO survey on eHealth as well as use of data from the World Bank, and Internet World Stats on global eHealth services.SettingA web-based survey on the use of eHealth in support of universal health coverage.Participants125 WHO member states provided response.Primary outcome measuresAvailability of eHealth services (eg, electronic health records, telehealth, etc) and governance frameworks (policies) for kidney care across ISN regions.ResultsThe survey conducted by the WHO received responses from 125 (64.4%) member states, representing 4.4 billion people globally. The number of mobile cellular subscriptions was <100% of the population in Africa, South Asia, North America and North East Asia; the percentage of internet users increased from 2015 to 2020 in all regions. Western Europe had the highest percentage of internet users in all the periods: 2015 (82.0%), 2019 (90.7%) and 2020 (93.9%); Africa had the least: 9.8%, 21.8% and 31.4%, respectively. The North East Asia region had the highest availability of national electronic health record system (75%) and electronic learning access in medical schools (100%), with the lowest in Africa (27% and 39%, respectively). Policies concerning governance aspects of eHealth (eg, privacy, liability, data sharing) were more widely available in high-income countries (55%–93%) than in low-income countries (0%–47%), while access to mobile health for treatment adherence was more available in low-income countries (21%) than in high-income countries (7%).ConclusionThe penetration of eHealth services across ISN regions is suboptimal, particularly in low-income countries. Increasing utilisation of internet communication technologies provides an opportunity to improve access to kidney education and care globally, especially in low-income countries.

IntroductionAn effective workforce is essential for optimal care of all forms of chronic diseases. The objective of this study was to assess workforce capacity for kidney failure (KF) care across world countries and regions.MethodsData were collected from published online sources and a survey was administered online to key stakeholders. All country-level data were analysed by International Society of Nephrology region and World Bank income classification.ResultsThe general healthcare workforce varies by income level: high-income countries have more healthcare workers per 10 000 population (physicians: 30.3; nursing personnel: 79.2; pharmacists: 7.2; surgeons: 3.5) than low-income countries (physicians: 0.9; nursing personnel: 5.0; pharmacists: 0.1; surgeons: 0.03). A total of 160 countries responded to survey questions pertaining to the workforce for the management of patients with KF. The physicians primarily responsible for providing care to patients with KF are nephrologists in 92% of countries. Global nephrologist density is 10.0 per million population (pmp) and nephrology trainee density is 1.4 pmp. High-income countries reported the highest densities of nephrologists and nephrology trainees (23.2 pmp and 3.8 pmp, respectively), whereas low-income countries reported the lowest densities (0.2 pmp and 0.1 pmp, respectively). Low-income countries were most likely to report shortages of all types of healthcare providers, including nephrologists, surgeons, radiologists and nurses.ConclusionsResults from this global survey demonstrate critical shortages in workforce capacity to care for patients with KF across world countries and regions. National and international policies will be required to build a workforce capacity that can effectively address the growing burden of KF and deliver optimal care.