The Impact of COVID-19 on Bicycle-Related Injuries Managed at a Level 1 Major Trauma Center in London, United Kingdom.

Introduction The COVID-19 pandemic changed peoples' travel behaviors; an uptake in cycling was observed in the United Kingdom. The aim of this study was to assess the cycling-related orthopedic injuries presented to a major trauma center (MTC) before and during the COVID-19 pandemic. Method This retrospective observational single-center study analyzed referrals to the orthopedic department during a matched two-month period in 2019 and 2020. Data were collated on cycling-related injuries including demographic variables, mechanism of injury, anatomical area of injury, and the management of injury. The data were compared and statistical analysis was performed using the Pearson Chi-squared test to assess for significance. Results A total of 2409 patients were referred to the orthopedic department with injuries. A 35.6% decrease in total referrals was made during the COVID-19 pandemic. Analysis of cycling-specific injuries demonstrated a statistically significant increase in referrals to the orthopedic department during the COVID-19 pandemic. A statistically significant difference in upper limb trauma was also observed during the COVID-19 pandemic. Patterns of management, namely operative vs. non-operative management, did not demonstrate a difference in the two time periods. Discussion This study highlights that during the COVID-19 pandemic, cycling behavior changed with more patients suffering orthopedic injuries as a result. Orthopedic departments may need to plan for this change in behaviors with more capacity being created to manage the demand. Conclusion Cycling-related injuries referred to the orthopedic department increased during the pandemic.

Efficacy of supplementing Aspergillus awamori in enhancing growth performance, gut microbiota, digestibility, immunity, and antioxidant activity of heat-stressed broiler chickens fed diets containing olive pulp.

BACKGROUND: Gut microbes play a significant role in digestion, developing immunity, and intestinal health. Therefore, direct-fed microbials are used to modify gut microbiota, maintain a healthy digestive system, enhance immunity, and promote the broilers' performance. In addition, it has a role in improving the utilization of unconventional feed ingredients (olive pulp, OP). This study provides the potential role of Aspergillus awamori in enhancing gut microbial content, nutrient utilization, growth performance, and antioxidative status in heat-stressed broiler chickens fed diets containing olive pulp. METHODS: Three hundred chicks (Ross 308; one day old) were divided into four treatment groups (75 chick/ group) randomly, as follows; CON: chicks fed a basal diet based on corn and soybean meal, OP10: chicks fed a diet containing 10% OP, OA1: chicks fed a diet containing OP with A. awamori at 100 mg per kg, OA2: chicks fed a diet containing OP with A. awamori at 200 mg per kg. RESULTS: Adding A. awamori to the broiler diet that contains OP had a positive effect on productive performance via enhancing nutrition digestibility, body weight gain, feed conversion ratio, and carcass characteristics. A. awamori supplementation had a positive impact on immune responses by increasing serum immunoglobulin G and the relative weight of bursa of Fabricius (P < 0.05) compared to the other groups. Chickens fed A. awamori showed a noticeable improvement in the oxidative status through the increase in the level of serum superoxide dismutase, and glutathione peroxidase, and the decrease in the level of malondialdehyde. Feeding A. awamori also modified the intestinal microbial content by increasing the population of Lactobacillus (P < 0.05). CONCLUSIONS: Our study indicated that adding 200 mg A. awamori reduced the negative effect of heat stress by modifying the microbial content of the intestine, immune response, and enhancing feed utilization, thus improving broiler performance, as well as, improving the nutritional value of the olive pulp. Therefore, adding A. awamori to the OP diet can be effectively used in heat-stressed broiler diets.

Accuracy of automated segmentation and volumetry of acute intracerebral hemorrhage following minimally invasive surgery using a patch-based convolutional neural network in a small dataset.

PURPOSE: In cases of acute intracerebral hemorrhage (ICH) volume estimation is of prognostic and therapeutic value following minimally invasive surgery (MIS). The ABC/2 method is widely used, but suffers from inaccuracies and is time consuming. Supervised machine learning using convolutional neural networks (CNN), trained on large datasets, is suitable for segmentation tasks in medical imaging. Our objective was to develop a CNN based machine learning model for the segmentation of ICH and of the drain and volumetry of ICH following MIS of acute supratentorial ICH on a relatively small dataset. METHODS: Ninety two scans were assigned to training (n = 29 scans), validation (n = 4 scans) and testing (n = 59 scans) datasets. The mean age (SD) was 70 (± 13.56) years. Male patients were 36. A hierarchical, patch-based CNN for segmentation of ICH and drain was trained. Volume of ICH was calculated from the segmentation mask. RESULTS: The best performing model achieved a Dice similarity coefficient of 0.86 and 0.91 for the ICH and drain respectively. Automated ICH volumetry yielded high agreement with ground truth (Intraclass correlation coefficient = 0.94 [95% CI: 0.91, 0.97]). Average difference in the ICH volume was 1.33 mL. CONCLUSION: Using a relatively small dataset, originating from different CT-scanners and with heterogeneous voxel dimensions, we applied a patch-based CNN framework and successfully developed a machine learning model, which accurately segments the intracerebral hemorrhage (ICH) and the drains. This provides automated and accurate volumetry of the bleeding in acute ICH treated with minimally invasive surgery.

Assessing different oil sources efficacy in reducing environmental heat-stress effects via improving performance, digestive enzymes, antioxidant status, and meat quality.

Adding oil to the feed of genetically improved broilers is necessary to provide energy requirements, in addition to enhancing metabolism, growth performance, immune response. This study aims to reveal the effect of adding different oil sources in the diets of broilers exposed to environmental heat stress on performance, digestibility, oxidative status, plasma lipids, fatty acids content, and meat quality. Six hundred twenty-five one-day-old broiler chicks were randomly distributed to five groups as follows: the first group fed a diet without oil (CON) as a control, while the second to the fifth group fed a diet containing soy oil (SO), corn oil (CO), olive oil (OO), and fish oil (FO), respectively. Results indicated a significant deterioration in growth performance, carcass traits, and oxidative state with a significant decrease in carcass quality in heat-stressed chickens fed the CON diet. Results showed increased growth, enhanced feed conversion ratio, and carcass dressing in broilers fed the oil-supplemented diet compared to the control diet, however, the digestive enzymes activity was not affected by receiving an oil-supplemented diet. The best performance was in chickens fed OO and SO, compared with FO and CO. Plasma aspartate aminotransferase (AST), and alanine aminotransferase (ALT) increased in broilers fed an oil-supplemented diet. Plasma high-density lipoprotein (HDL), and superoxide dismutase (SOD) remarkably increased in broilers fed OO, whereas the malondialdehyde (MDA) decreased compared to the other groups. Adding different dietary oil sources enhanced the breast muscle's fatty acid composition. Broiler diets supplemented with oils positively affected meat quality by enhancing color measurements, and TBA values, while the best were in chicken fed OO. It was concluded that adding dietary oil at 3% in the diets of broiler chicken exposed to environmental heat stress positively affected growth performance, enhanced oxidative status, and meat quality, best results were in broilers fed a diet that included olive oil.

Effectiveness of probiotics and clove essential oils in improving growth performance, immuno-antioxidant status, ileum morphometric, and microbial community structure for heat-stressed broilers.

Recently, interest has increased in using bio-additives, herbs, and their extracts as feed additives because of their potential role in improving chick's health and productivity, especially during stress. Thus, our aim in this study is to examine whether nutritional supplementation (probiotics and clove essential oils) will help mitigate the negative effect of heat stress on the bird by modifying the microbial content, boosting immunity, oxidative status, metabolic, and growth. In this study, three hundred one-day-old broiler chicks (Ross 308) were fed the following experimental diet: (CON) basal diet (control diet); (CEO) CON with clove essential oils (300 mg/kg); (PRO) CON with probiotics (2 g/kg); (PC) CON with probiotics and clove essential oils. Our results showed a significant improvement (P < 0.05) in body weight gain, feed conversion ratio, nutrient digestibility, and digestive enzymes activities in broilers fed on PC, CEO, and PRO compared to the control group. Moreover, a significant decrease was recorded in the abdominal fat content and an increase in the relative weight of bursa of Fabricius, and higher antibody levels against Newcastle disease virus, as well as, there was an increase (P < 0.05) in interleukin 10 (IL-10) in all treated groups. Meanwhile, there was a decrease in tumor necrosis factor-α (TNF-α) in all supplemented groups compared with the control group. Serum triglycerides, cholesterol, low-density lipoprotein concentrations, and alanine aminotransferase activities were significantly lower in the treated groups. Superoxide dismutase and glutathione peroxidase levels were elevated (P < 0.05) and the malondialdehyde level value significantly decreased in all supplemented groups. The treated groups enhanced the ileum structure by increasing Lactobacillus, decreasing E. coli, and improving the morphometrically (P < 0.05). This study strongly suggests that clove essential oil and probiotic mixture can be used as a feed supplement to reduce the effects of heat stress by improving the growth performance and enhancing immuno-antioxidant status, ileum morphometric, as well as modifying the microbial community structure of the ileum of broilers.

Growth performance, digestive function, thyroid activity, and immunity of growing rabbits fed olive cake with or without Saccharomyces cerevisiae or citric acid.

The present study investigated the impact of dietary inclusion of olive cakes (OC) with or without Saccharomyces cerevisiae (SC) and citric acid (CA) on growth, digestive function, thyroid activity, antioxidant status, immunity, and intestinal architecture of growing rabbits. One hundred forty 35-day-old male New Zealand white rabbits were randomly assigned into seven experimental groups with five replicates each, as follows: control (CN), fed the basal diet; OC20 and OC25, fed diets with 20 and 25% OC; OS20 and OS25, fed diets containing 20 and 25% OC with S. cerevisiae at 5 g/kg diet; OA20 and OA25, fed diets supplemented with 20 and 25% OC with 1.0% citric acid. No differences in live body weight, feed intake, feed conversion ratio, and carcass traits were noticed among experimental groups, while body weight gain and carcass (%) were increased (P < 0.05) in OS20 compared to the control. Digestibility coefficients of all nutrients and activities of amylase, cellulose, and trypsin did not differ in treated groups compared to the control except for OS20, which recorded enhancement in nutrient digestibility. Plasma triiodothyronine and thyroxine were elevated (P < 0.05), while triglycerides and cholesterol were reduced (P < 0.05) in OS20 compared to CN. Plasma concentrations of immunoglobulin M and G and superoxide dismutase were increased in treated groups compared to the control. Dietary inclusion of SC and CA improved rabbits' intestinal health, as the cecal Lactobacillus count was increased, E. coli count was decreased, and villus height was elevated in SC- and CA-treated groups. In conclusion, dietary incorporation of SC or CA enhanced the nutritional value of OC and improved growth performance, nutrient digestibility, thyroid activity, antioxidative status, and gut health of growing rabbits.

Concerns about stone free rate and procedure events of percutaneous nephrolithotripsy (PCNL) for 2-4 cm kidney stones by standard-PCNL vs mini-PCNL- comparative randomised study.

BACKGROUND: To compare the efficacy and safety of standard percutaneous nephrolithotomy (PCNL) with mini- PCNL for kidney stones 2-4 cm. METHODS: Eighty patients were enrolled in a comparative study, they were randomly divided into mini-PCNL group (n = 40) and standard-PCNL (n = 40). Demographic characteristics, perioperative events, complications, stone free rate (SFR) were reported. RESULTS: Both groups showed no significant difference in clinical data about age, stone location, back pressure changes, and body mass index. The mean operative time was (95 ± 17.9 min) in mini-PCNL, and (72.1 ± 14.9 min). Stone free rate were 80% and 85% in mini-PCNL and standard-PCNL respectively. Intra-operative complications, post-operative need for analgesia, hospital stay were significantly higher in standard-PCNL compared to mini-PCNL (85% vs. 80%). The study followed CONSORT 2010 guidelines for reporting parallel group randomization. CONCLUSION: Mini-PCNL is an effective and safe treatment of kidney stones 2-4 cm, it has the advantage over standard-PCNL being has less intra-operative events, less post-operative analgesia, shorter hospital stay, while operative time and stone free rate are comparable when considering multiplicity, hardness, and site of stones.

Growth performance, nutrient digestibility, antioxidant state, ileal histomorphometry, and cecal ecology of broilers fed on fermented canola meal with and without exogenous enzymes.

This study was conducted to evaluate the effects of supplementation of exogenous enzymes in broiler diets that includes fermented canola meal on performance, nutrient digestibility, biochemical indication, antioxidative capacity, digestive enzyme activity, immune responses, and gut health. Five hundred 1-day-old Ross 308 broiler chicks were randomly allocated into five experimental groups (5 replicate/group), the first group: a control (CON) contained a basal diet, and the second to the fifth groups were fed diets as follows: containing 20% canola meal (CM), contains 20% fermented canola meal (FCM), contains 20% canola meal and exogenous enzymes at 0.02%/kg feed (ECM), and contains 20% fermented canola meal and exogenous enzymes at 0.02%/kg feed (EFC), respectively. At the finisher phase, the best body weight gain, feed conversion ratio, and nutrient utilization were associated with chickens fed EFC compared to other groups (P < 0.05). Total protein, albumin, alanine aminotransferase, and superoxide dismutase levels increased (P < 0.05), while cholesterol and malondialdehyde levels decreased in chickens fed on EFC. Likewise, there was a significant increase in the relative weight of the bursa of Fabricius and antibody titer against Newcastle disease, whereas the weight of abdominal fat decreased in the EFC group compared to other groups. Furthermore, there was a significant improvement in the activity of lipase and amylase enzymes (P < 0.05) in the EFC group. Fermented canola meal addition improved gut health (decreased Escherichia coli, increased Lactobacillus, and the highest values of villus height). Overall, these results confirmed that supplementing a fermented canola meal diet with exogenous enzymes improved growth performance through enhancing nutrient digestibility, immunity, antioxidant capacity, and gut health. Thus, adding enzymes to a diet containing fermented canola meal can be recommended as an alternative protein source that could be safely used to replace up to 20% soybean meal in broiler diets.

Adult skin fibroblast state change in murine wound healing.

Wound healing is a well-organized dynamic process involving coordinated consecutive phases: homeostasis, inflammation, proliferation and resolution. Fibroblasts play major roles in skin wound healing such as in wound contraction and release of growth factors which are of importance in angiogenesis and tissue remodeling. Abnormal fibroblast phenotypes have been identified in patients with chronic wounds. In this work, we analyzed scRNA-seq datasets of normal and wounded skin from mice at day 4 post-wound to investigate fibroblast heterogeneity during the proliferative phase of wound healing. Compositional analysis revealed a specific subset of fibroblast (cluster 3) that primarily increased in wounded skin (14%) compared to normal skin (3.9%). This subset was characterized by a gene signature marked by the plasma membrane proteins Sfrp2 + Sfrp4 + Sfrp1 + and the transcription factors Ebf1 + Prrx1 + Maged1 + . Differential gene expression and enrichment analysis identified epithelial to mesenchymal transition (EMT) and angiogenesis to be upregulated in the emerging subset of fibroblasts of the wounded skin. Using two other datasets for murine wounded skin confirmed the increase in cluster 3-like fibroblasts at days 2, 7 and 14 post-wounding with a peak at day 7. By performing a similarity check between the differential gene expression profile between wounded and normal skin for this emerging fibroblast subset with drug signature from the ConnectivityMap database, we identified drugs capable of mimicking the observed gene expression change in fibroblasts during wound healing. TTNPB, verteprofin and nicotinic acid were identified as candidate drugs capable of inducing fibroblast gene expression profile necessary for wound healing. On the other hand, methocarbamol, ifosfamide and penbutolol were recognized to antagonize the identified fibroblast differential expression profile during wound healing which might cause delay in wound healing. Taken together, analysis of murine transcriptomic skin wound healing datasets suggested a subset of fibroblasts capable of inducing EMT and further inferred drugs that might be tested as potential candidates to induce wound closure.

Effects of garlic and lemon essential oils on performance, digestibility, plasma metabolite, and intestinal health in broilers under environmental heat stress.

BACKGROUND: Natural feed additives play an important role in poultry production due to their safety and potential properties as an antioxidant and antimicrobial, as well as a growth stimulant. The present research was designed to assess the influence of dietary supplementation of either garlic, lemon essential oil, or their mixture on performance, nutrient digestibility, plasma constituents, immunity, and oxidative status, as well as intestinal development assessed by microbiota-histomorphology development in broilers under environmental heat stress. METHODS: A total of 480 broiler chicks (Ross 308) at one-day-old were randomly divided into four groups (120 chicks/ group). The control group received the basal diet (CON), while the other three groups received the basal diet supplemented with 200 mg/kg garlic essential oil (GEO), 200 mg/kg lemon essential oil (LEO), and their mixture (GLO) 200 mg/kg diet, respectively for 35 days. RESULTS: The obtained results revealed that broilers fed essential oils as a mixture or individually had an improvement in average body weight, feed conversion ratio, carcass dressing, and an increase in digestive enzymes activities compared to the control group, furthermore, there was a reduction in the mortality rate and abdominal fat content. Adding essential oils as a mixture or individually led to a decrease in (P < 0.05) blood plasma triglycerides, cholesterol, low-density lipoprotein, and an increase in high-density lipoprotein. Broilers fed diets supplemented with essential oils as a mixture or individually had higher values of superoxide dismutase and glutathione peroxidase; while plasma malondialdehyde was lower (P < 0.05) compared to the control diet. Moreover, there was a significant enhancement in intestinal microbial content, and intestinal histological status of chickens fed with essential oils. CONCLUSIONS: Conclusively, including the mixture of essential oils improved performance, nutrient digestibility, and digestive enzymes activities. It also enhanced immunity, antioxidant state, and lipid profile, and gut microbiota- histomorphology in broilers. It was proposed that the broilers diet be supplemented with a mixture of essential oils to a mitigation of the effects of heat stress.

Potential ameliorative role of Spirulina platensis in powdered or extract forms against cyclic heat stress in broiler chickens.

Global warming has become intensified and widespread, threatening the world with causing acute heatwaves that adversely affect poultry production and producers' profitability. Spirulina platensis is a precious and promising mitigating strategy to combat the detrimental impacts of heat stress due to its high contents of nutrients and bioactive components. The current study was designed to compare the incorporation impact of S. platensis powder or aqueous extract on the growth and physiological responses of heat-stressed broiler chicks. Six hundred 1-day-old Ross 308 male broiler chicks were allocated into five experimental groups with six replicates of 20 chicks each. The control group fed the basal diet without additives, SPP1 and SPP2 groups fed the basal diet with 1 g/kg and 2 g/kg S. platensis powder, respectively, while SPE1 and SPE2 groups received 1 ml/L and 2 ml/L S. platensis aqueous extract in the drinking water, respectively. All birds were exposed to cyclic heat stress (34 ± 2 °C for 12 h) for three successive days a week from day 10 to day 35. In vitro analysis showed that total phenols, flavonoids, and antioxidant activity of S. platensis were remarkably decreased (P < 0.001) in the aqueous extract compared to the powder form. Body weight, weight gain, and feed conversion ratio were improved (P < 0.001) in all treated groups, while carcass yield and dressing percentage were increased only in SPP1 and SPP2. Feed and water intake and blood biochemical parameters were not affected. Both forms of S. platensis enhanced the lipid profile, redox status, and humoral immune response of heat-stressed chicks superior to the powder form. Conclusively, the powder form of S. platensis was more effective in enhancing the productivity of broilers and alleviating the negative impacts of heat stress than the aqueous extract form.

Synergistic effect of Spirulina platensis and selenium nanoparticles on growth performance, serum metabolites, immune responses, and antioxidant capacity of heat-stressed broiler chickens.

This study examined the effects of dietary Spirulina platensis (SP) at levels of 0, 5, and 10 g.kg-1 and selenium nanoparticles (SeNPs) at 0, 0.1, and 0.2 mg.kg-1, individually and in combination, on heat-stressed broiler chickens for 5 weeks. Four hundred fifty one-day-old Ross-308 chicks were allocated to 9 dietary groups with 5 replicates (10 chicks each). The control diet was consisted of corn-soybean-based basal diet. The obtained results displayed a significant increase in final body weight (p = 0.005) and weight gain during the periods from 22 to 35 days (p = 0.002) and 1 to 35 days (p = 0.005) in birds fed supplemented diets compared to those fed control diet, with the highest being in birds fed with both 10 g SP and 0.1 mg SeNPs. Feed conversion ratio was also improved in birds fed supplemented compared to control group. Dietary supplements significantly improved carcass dressing (p < 0.001), carcass yield (p = 0.001) percentages, and blood lipid profile. Blood triiodothyronine was higher (p = 0.005) with all treated diets except that contain 5 g SP compared to the control, with the highest being in birds fed diet contains 5 g SP + 0.2 mg SeNPs. Immunoglobulin subclasses IgG, IgM, and IgA were higher in birds fed supplemented diets compared to the control group. Antibody titers to Newcastle disease, avian influenza, and infectious bursal disease were numerically increased with dietary supplementation compared to the control group. Dietary treatments increased (p < 0.001) glutathione peroxidase and superoxide dismutase (SOD) levels, except diet contains 5 g SP for SOD level and decreased (p < 0.001) malondialdehyde level. It is concluded that dietary inclusion of SP and SeNPs, particularly their combination at levels 5 g SP plus 0.2 mg SeNPs kg-1 and 10 g SP plus 0.1 mg SeNPs kg-1, improved growth performance, carcass yield, immunity, and antioxidant capacity of heat-stressed broilers.

Characterization of Crohn's disease patients in Egypt: Risk factors for postoperative recurrence (A cohort study).

BACKGROUND: The aim of study to identify the characterizations of Crohn's disease in Egyptian patients and to determine its predictors for postoperative recurrence. METHODS: We conducted a retrospective observational cohort study on 15 patients diagnosed as Crohn's disease with surgical interventions. Different characteristics of studied patients were analyzed to determine the risk factors for postoperative recurrence such as age at diagnosis, gender, smoking, main presenting symptom, Montreal classification, perianal disease, laboratory findings and protocol of management including surgical characteristics like age at operation, surgical indication, preoperative medication, surgical approach, and operative findings. RESULTS: Nine of the studied patients (60%) suffered from clinical postoperative recurrence with mean duration of 23.5 ± 40.6 months. In comparison the demographic, clinical, operative, and medical treatment data between patients with postoperative recurrence of Crohn's disease and those without recurrence, age at diagnosis (mean age 42.9 years) and age at operation (mean 44.7 years) were found statistically significant in postoperative recurrence group (p-value = 0.001). According to Montreal classification of Crohn's disease, patients >40 years were significantly found in postoperative recurrence group, while patients between 17 and 40 years were significantly found in postoperative non-recurrence group (p-value=0.007) and ileal location of Crohn's disease was found significantly in postoperative recurrent group (p-value=0.044). Postoperative biological therapy significantly decreased the incidence of postoperative recurrence in the current study (p-value= 0.041). CONCLUSIONS: Age at diagnosis, age at operation, ileal location of Crohn's disease can significantly predict postoperative recurrence. Also, postoperative biological therapy can significantly decrease the incidence of postoperative recurrence.

Egyptian clinical practice guideline for kidney transplantation.

Objective: To present the first Egyptian clinical practice guideline for kidney transplantation (KT). Methods: A panel of multidisciplinary subspecialties related to KT prepared this document. The sources of information included updates of six international guidelines, and review of several relevant international and Egyptian publications. All statements were graded according to the strength of clinical practice recommendation and the level of evidence. All recommendations were discussed by the panel members who represented most of the licensed Egyptian centres practicing KT. Results: Recommendations were given on preparation, surgical techniques and surgical complications of both donors and recipients. A special emphasis was made on the recipient's journey with immunosuppression. It starts with setting the scene by covering the donor and recipient evaluations, medicolegal requirements, recipient's protective vaccines, and risk assessment. It spans desensitisation and induction strategies to surgical approach and potential complications, options of maintenance immunosuppression, updated treatment of acute rejection and chemoprophylactic protocols. It ends with monitoring for potential complications of the recipient's suppressed immunity and the short- and long-term complications of immunosuppressive drugs. It highlights the importance of individualisation of immunosuppression strategies consistent with pre-KT risk assessment. It emphasises the all-important role of anti-human leucocyte antigen antibodies, particularly the donor-specific antibodies (DSAs), in acute and chronic rejection, and eventual graft and patient survival. It addresses the place of DSAs across the recipient's journey with his/her gift of life. Conclusion: This guideline introduces the first proposed standard of good clinical practice in the field of KT in Egypt. Abbreviations: Ab: antibody; ABMR: Ab-mediated rejection; ABO: ABO blood groups; BKV: BK polyomavirus; BMI: body mass index; BTS: British Transplantation Society; CAN: chronic allograft nephropathy; CDC: complement-dependent cytotoxicity; CKD: chronic kidney disease; CMV: cytomegalovirus; CNI: calcineurin inhibitor; CPRA: Calculated Panel Reactive Antibodies; (dn)DSA: (de novo) donor-specific antibodies; ECG: electrocardiogram; ESWL: extracorporeal shockwave lithotripsy; FCM: flow cytometry; GBM: glomerular basement membrane; GN: glomerulonephritis; HIV: human immunodeficiency virus; HLA: human leucocyte antigen; HPV: human papilloma virus; IL2-RA: interleukin-2 receptor antagonist; IVIg: intravenous immunoglobulin; KT(C)(R): kidney transplantation/transplant (candidate) (recipient); (L)(O)LDN: (laparoscopic) (open) live-donor nephrectomy; MBD: metabolic bone disease; MCS: Mean channel shift (in FCM-XM); MFI: mean fluorescence intensity; MMF: mycophenolate mofetil; mTOR(i): mammalian target of rapamycin (inhibitor); NG: 'not graded'; PAP: Papanicolaou smear; PCN: percutaneous nephrostomy; PCNL: percutaneous nephrolithotomy; PKTU: post-KT urolithiasis; PLEX: plasma exchange; PRA: panel reactive antibodies; PSI: proliferation signal inhibitor; PTA: percutaneous transluminal angioplasty; RAS: renal artery stenosis; RAT: renal artery thrombosis;:rATG: rabbit anti-thymocyte globulin; RCT: randomised controlled trial; RIS: Relative MFI Score; RVT: renal vein thrombosis; TB: tuberculosis; TCMR: T-cell-mediated rejection; URS: ureterorenoscopy; (CD)US: (colour Doppler) ultrasonography; VCUG: voiding cystourethrogram; XM: cross match; ZN: Ziehl-Neelsen stain.

Nutritional manipulation to combat heat stress in poultry - A comprehensive review.

Global warming and climate change adversely affect livestock and poultry production sectors under tropical and subtropical conditions. Heat stress is amongst the most significant stressors influencing poultry productivity in hot climate regions, causing substantial economic losses in poultry industry. These economic losses are speculated to increase in the coming years with the rise of global temperature. Moreover, modern poultry strains are more susceptible to high ambient temperature. Heat stress has negative effects on physiological response, growth performance and laying performance, which appeared in the form of reducing feed consumption, body weight gain, egg production, feed efficiency, meat quality, egg quality and immune response. Numerous practical procedures were used to ameliorate the negative impacts of increased temperature; among them the dietary manipulation, which gains a great concern in different regions around the world. These nutritional manipulations are feed additives (natural antioxidants, minerals, electrolytes, phytobiotics, probiotics, fat, and protein), feed restriction, feed form, drinking cold water and others. However, in the large scale of poultry industry, only a few of these strategies are commonly used. The current review article deliberates the different practical applications of useful nutritional manipulations to mitigate the heat load in poultry. The documented information will be useful to poultry producers to improve the general health status and productivity of heat-stressed birds via enhancing stress tolerance, oxidative status and immune response, and thereby provide recommendations to minimize production losses due to heat stress in particular under the growing global warming crisis.

Comparative evaluation of single or combined anticoccidials on performance, antioxidant status, immune response, and intestinal architecture of broiler chickens challenged with mixed Eimeria species.

Poultry production faces several threats and challenges, one of the most important of which is avian coccidiosis which causes annual losses exceeding US$ 3 billion. Discovering new drugs or combinations of existing anticoccidials has become inevitable to overcome the emergence of coccidiosis resistance. This study evaluated a new combination of maduramicin and diclazuril in comparison to the well-known product Maxiban72 which consisted of narasin and nicarbazin, and the single effect of monensin as treatments for avian coccidiosis. A total of 750 1-day-old Indian River broiler chicks were allocated equally into 5 experimental groups with 6 replicates each as follows: 1) negative unchallenged control group (NC) fed the basal diet; 2) positive control group (PC) received the basal diet and inoculated with Eimeria; 3) PC + 100 mg monensin sodium (Atomonsin)/kg diet (MS); 4) PC + 5 mg maduramicin ammonium (Madramycin) + 2.5 mg diclazuril (Atozuril)/kg diet (MMD); and 5) PC + 40 mg narasin + 40 mg nicarbazin (MaxibanT72)/kg diet (NN). Anticoccidials improved (P < 0.01) growth performance, dressing (%) and carcass yield of inoculated birds compared to untreated-inoculated ones. Erythrogram and leukogram parameters were affected by Eimeria challenge. Total protein, globulin, cholesterol, triglycerides, superoxide dismutase and glutathione peroxidase levels in PC birds' serum were reduced (P < 0.05) while their values of liver enzymes, malondialdehyde and catalase were elevated (P < 0.01) when compared to NC ones. Serum immunoglobulin A, and jejunal gene expressions of interleukin-6 and interferon gamma were increased (P < 0.05) in PC group compared to NC group. Anticoccidial drugs restored values of the aforementioned biomarkers near to those of NC. Jejunal architecture in inoculated birds was improved by the anticoccidial treatments in MS, MMD, and NN. Fecal oocyst counts were significantly reduced in MMD, NN, and MS groups compared to PC group. Conclusively, although all examined anticoccidial drugs were effective in treating Eimeriosis, the anticoccidial combinations in MMD and NN groups were more effective than the single administration of MS in treating avian coccidiosis.

Impact of multi-strain probiotic, citric acid, garlic powder or their combinations on performance, ileal histomorphometry, microbial enumeration and humoral immunity of broiler chickens.

Heat stress, one of the critical obstacles to poultry sector in subtropical and tropical countries, reduces performance, immune response, and animal welfare. This study examined the effect of dietary inclusion of probiotic (PRO), citric acid (CIT), garlic powder (GAR) or their combinations on growth, blood constituents, ileal microflora and morphology and humoral immunity of broiler chickens subjected to cyclic heat stress. Four hundred ninety one-day-old Ross-308 broiler chicks were randomly allocated to 7 groups with 7 replicates of 10 birds each as follows: control (C) group received the basal diet without supplements, PRO, CIT and GAR groups supplemented with 0.5 g kg-1 multi-strain probiotic mixture (MPM), citric acid and garlic powder, respectively. PRO-CIT and PRO-GAR groups treated with 0.5 g kg-1 MPM, and 0.5 g kg-1 citric acid and garlic powder, while CIT-GAR group fed diet with 0.5 g kg-1 of citric acid and garlic powder. Results revealed that dietary supplements and their combinations improved (P < 0.001) growth performance and decreased abdominal fat of heat-stressed birds. Dietary supplements decreased (P < 0.01) serum concentrations of cholesterol, triglycerides and LDL, while HDL was elevated (P < 0.05). Feed additives reduced (P < 0.01) ileal enumeration of Escherichia coli and total coliform while Lactobacillus count was increased (P < 0.05) only in MPM-enriched groups. Supplementation of these natural products improved (P < 0.01) ileal architecture while humoral immune response was not significantly influenced except antibody titre against Newcastle disease virus which was increased (P < 0.05) in MPM-supplemented groups. Conclusively, addition of the dietary supplements and their combinations, particularly, probiotic and citric acid combination can improve productive performance, and intestinal flora and histomorphometry of broilers exposed to cyclic heat stress.

The COVID-19 pandemic: The mitigating role of government and hotel support of hotel employees in Egypt.

We investigated the effect of government support of hotels on hotels' employee support (namely, health support, staff retention, and staff training) and consequently on employee job satisfaction and organizational commitment, through the moderating role of perceived overall organizational justice and ethical climate, during the COVID-19 pandemic. Using a quantitative approach and a framework that drew on the stakeholder and organizational support theories, we collected data from 669 employees in Egyptian hotels through a web-based survey. The results support the proposed framework and show a positive effect of government support through the strengthened perception of perceived overall organizational justice. Surprisingly, findings indicated that the association between job satisfaction and organizational commitment is significantly and negatively influenced by hotel ethical climate. Furthermore, job satisfaction partially mediates the association between hotels' support of employees and organizational commitment. The study holds important implications for both theory and practice.

Comparative study between bowel ultrasound and magnetic resonance enterography among Egyptian inflammatory bowel disease patients.

BACKGROUND: Bowel ultrasound and magnetic resonance enterography (MRE) are decisive medical imaging modalities for diagnosing and locating bowel lesions with its extramural extent and complications. They assess the degree of activity, help clinicians to identify patients in need of surgery, and can be used for patient follow-up. AIM: To compare the role of MRE and bowel ultrasound in diagnosis and follow-up of inflammatory bowel disease (IBD) patients in Egypt. METHODS: The study was conducted on 40 patients with IBD. All patients were subjected to clinical assessment, laboratory investigations, bowel ultrasound, MRE, and colonoscopy up to the terminal ileum with biopsies for histopathological examination. RESULTS: This study was conducted on 14 patients (35%) with ulcerative colitis and 26 patients (65%) with Crohn's disease; 34 (85%) of these patients had active disease. Bowel ultrasound detected different bowel lesions with the following accuracies: ileum (85%), large bowel (70%), fistula (95%), stricture and proximal dilatation (95%) and abscesses (100%). Also, it showed that statistically significance of bowel ultrasound in differentiation between remission and activity of IBD in comparison to MRE and colonoscopy. CONCLUSION: In comparison to MRE, bowel ultrasound is a useful, non-invasive, and feasible bedside imaging tool for the detection of inflammation, detection of complications, and follow-up of IBD patients when performed by the attending physician.