Evaluation of antiviral activity of Carica papaya leaves against SARS-CoV-2 assisted by metabolomic profiling.

The COVID-19 pandemic caused a huge health crisis all over the globe. SARS-CoV-2 is the virus responsible for the disease and it is highly contagious leaving millions of confirmed infected cases and a dangerous death toll. Carica papaya is a tropical plant known for its antiviral activity since it possesses different classes of compounds that are believed to combat various viral classes. In this study, the extracts prepared from C. papaya leaves cultivated in Egypt were evaluated for their anti-SARS-CoV-2 activity using crystal violet assay and for their cytotoxicity through MTT assay. The total methanolic extract, n-hexane, ethyl acetate, and n-butanol fractions of papaya leaves were used in the study and the results revealed that the n-hexane fraction has a high anti-SARS-CoV-2 activity with an IC50 value = 1.98 µg mL-1. Moreover, it also showed a high selectivity index value = 104.7. Dereplication of the secondary metabolites in the crude methanolic extract of C. papaya leaves revealed the presence of different classes of compounds including sterols, terpenes, fatty acid, alkaloids and flavonoids that are known to possess antiviral activities against various classes of viruses. The current study was assisted by molecular docking, molecular dynamics simulation and MM-PBSA calculations for the annotated compounds against 6 SARS-CoV-2 target proteins. The results of these in silico-based investigations showed high to moderate binding on the targeted proteins. This postulation may instigate further research studies concerning the compounds responsible for this high anti-SARS-CoV-2 activity of the n-hexane fraction of C. papaya leaves.

Future of industry 5.0 in society: human-centric solutions, challenges and prospective research areas.

Industry 4.0 has been provided for the last 10 years to benefit the industry and the shortcomings; finally, the time for industry 5.0 has arrived. Smart factories are increasing the business productivity; therefore, industry 4.0 has limitations. In this paper, there is a discussion of the industry 5.0 opportunities as well as limitations and the future research prospects. Industry 5.0 is changing paradigm and brings the resolution since it will decrease emphasis on the technology and assume that the potential for progress is based on collaboration among the humans and machines. The industrial revolution is improving customer satisfaction by utilizing personalized products. In modern business with the paid technological developments, industry 5.0 is required for gaining competitive advantages as well as economic growth for the factory. The paper is aimed to analyze the potential applications of industry 5.0. At first, there is a discussion of the definitions of industry 5.0 and advanced technologies required in this industry revolution. There is also discussion of the applications enabled in industry 5.0 like healthcare, supply chain, production in manufacturing, cloud manufacturing, etc. The technologies discussed in this paper are big data analytics, Internet of Things, collaborative robots, Blockchain, digital twins and future 6G systems. The study also included difficulties and issues examined in this paper head to comprehend the issues caused by organizations among the robots and people in the assembly line.

Sentiment Analysis on USA vs. New Zealand on Health and Safety Mandates During Early Stages of COVID-19 Pandemic.

The Coronavirus pandemic has surprised the world and social media was extremely used to express frustrations and development of the cases found. Social media tools, such as Twitter, show a comparable impact with the number of tweets related to COVID-19 indicating remarkable development in a limited ability to focus time. The purpose of this paper is to investigate the impact of Coronavirus on the United States of America (USA) and New Zealand (NZ), and how that is reflected in a sentiment analysis through the examination of American and New Zealand tweets. We have gathered tweets from a March 2020 - August 2020 and used sentiment extraction on the tweets. The major finding of this sentiment extraction is the fact that the overall average sentiment over the 5-month period stayed in a negative range in the USA and NZ. This paper aims to analyze these trends, identify patterns, and determine whether these trends were caused by the COVID-19 pandemic or outside sources. One trend that was analyzed was the spike of COVID-19 results in relation to the number of protests occurring in the USA.

Production of di-(2-ethylhexyl) phthalate by Bacillus subtilis AD35: Isolation, purification, characterization and biological activities.

The emergence of extensive antibiotics resistant bacteria increased the demands for finding out new sources of antimicrobial agents. Marine niches were reported to be rich in many competent producers of significant bioactive compounds. On the course of screening program for new antimicrobials, a Bacillus strain was isolated from Alexandria sea shores, Egypt. According to the morphological, cultural and biochemical characteristics, 16S rRNA sequence analysis and matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS), the strain was identified as Bacillus subtilis and designated as B. subtilis AD35. One phthalate derivative namely Di-(2-ethylhexyl) phthalate (DEHP) was purified from the crude extract of B. subtilis AD35 by high performance liquid chromatography (HPLC) and the structural elucidation of this compound was confirmed on the basis of gas chromatography-mass spectroscopy (GC-MS), Fourier infrared spectroscopy (FT-IR) and UV spectrum. The results of MIC of the purified DEHP were as follow: 16 µg/ml (Salmonella typhimurium), 32 µg/ml (Methicillin resistant Staphylococcus aureus, MRSA), 0.25 µg/ml (Listeria monocytogenes), 0.5 µg/ml (Aeromonas hydrophila), 8 µg/ml (Staphylococcus aureus), 4 µg/ml (Staphylococcus epidermidis), 4 µg/ml (Escherichia coli), and 8 µg/ml (Pseudomonas aeruginosa). DEHP produced by B. subtilis AD35 up to a concentration of 2500 µg/ml exhibited no cytotoxic effect against normal Vero cells. In addition, it did not show an antiviral activity against HAV or a significant growth inhibitory effect toward human colorectal adenocarcinoma and human mammary gland adenocarcinoma cell-lines.

Disruptive physician behaviors and their impact on patient care in a health insurance hospital in Alexandria, Egypt.

BACKGROUND: Disruptive behavior is the use of inappropriate words, actions, or inactions by physicians that interferes with their ability to function well with others. It is a current problem in the medical profession and has become a focus of public health attention due to its destructive impact on hospital staff, institutions, and quality patient care. AIM: The aim of the present study was to evaluate the perceptions of physicians about disruptive physician behaviors, and their frequency and impact on clinical outcomes. MATERIALS AND METHODS: This cross-sectional, descriptive study was carried out in one of the hospitals of the Health Insurance Organization in Alexandria, Egypt. A self-administered questionnaire based on the American College of Physician Executives and QuantiaMD Survey on disruptive physician behavior was used to measure the physicians' perceptions. It was distributed to all physicians in all the departments (n=183). The number of returned questionnaires was 120, with a response rate of 65.6%. RESULTS: Most of the respondents (93.3%) were concerned about disruptive physician behavior, 39.2% previously had such behaviors, and 78.3% had one incident at least monthly. Most respondents (98.3%) said that disruptive physician behavior affects patient care. Physicians agreed that they needed training on how to deal with disruptive behavior. The most frequent behavior was refusal to cooperate with other providers (74.2%). Disruptive behavior was attributed to workload by 35% of the respondents. CONCLUSION AND RECOMMENDATIONS: Disruptive physician behaviors are common in healthcare settings, with the most frequent behavior being refusal to cooperate with other providers. Training of physicians on team dynamics, communication skills, conflict management, and stress management is highly recommended.

Prevalence and pattern of abnormal myocardial perfusion in patients with isolated coronary artery ectasia: study by 99mTc-sestamibi radionuclide scintigraphy.

We explored the prevalence and pattern of abnormal myocardial perfusion in patients with isolated coronary artery ectasia (CAE), as demonstrated by (99m)Tc-sestamibi scintigraphy. Prospectively, we enrolled 35 patients with angiographically documented CAE and no significant coronary obstruction, who underwent elective coronary angiography. Patients underwent Stress-rest (99m)Tc-sestamibi scintigraphy within 4 days of coronary angiography. They were divided into 2 groups: group I: with normal perfusion scan; and group II: with reversible perfusion defects. The mean age was 49.6 ± 6.9 years; 34 (97.1 %) were males. Seventy-nine (75.2 %) arteries were affected by CAE. Among 79 arteries affected by CAE, affection was diffuse in 37 (46.8 %). Thirteen (37.1 %) patients had normal perfusion scan (group I), whereas 22 (62.9 %) had reversible perfusion defects (group II). Among 22 patients with reversible perfusion defects, 20 (90.9 %) had mild and 2 (9.1 %) had moderate ischemia. Among 49 myocardial segments with reversible perfusion defects, 22 (44.9 %) were basal, 18 (36.7 %) mid-, and 9 (18.4 %) apical segments. Diffuse CAE was significantly more prevalent in group II versus group I, in all 3 major coronary arteries (p < 0.05 for all). In patients with isolated CAE who underwent elective coronary angiography, reversible perfusion defects demonstrated by (99m)Tc-sestamibi scintigraphy were rather prevalent, mostly mild, more likely to affect the basal and mid-segments of the myocardium, and more frequently associated with diffuse ectasia.

Routine invasive versus ischemia-guided strategy in patients with acute inferior ST-elevation myocardial infarction who received fibrinolytic therapy: a prospective randomized controlled pilot trial.

AIMS: We sought to compare a routine invasive strategy of early coronary angiography and intended revascularization, with an ischemia-guided strategy in patients with acute inferior ST-elevation myocardial infarction (STEMI) who received fibrinolytic therapy. METHODS: We enrolled 60 consecutive patients with acute inferior STEMI who received fibrinolytic therapy within 6 hours. Patients were randomly assigned to either a routine invasive strategy in which coronary angiography was performed within 48 hours with intended revascularization if eligible (Group A), or an ischemia-guided strategy in which catheterization was based on the presence of myocardial ischemia and viability as demonstrated by stress myocardial perfusion imaging (Group B). Patients were prospectively followed up for 6 months. The primary endpoint was a composite of cardiac death, recurrent myocardial infarction, recurrent ischemia or stroke at 6-month follow-up. Total costs per patient were calculated over 6 months. RESULTS: The mean age of the whole series was 52 ± 9.8 years (15% females). The primary endpoint occurred more frequently in group A as compared to group B, however, the difference did not meet statistical significance (36.7% versus 23.3%, respectively, p > 0.05). The mean cost per patient at 6-month follow-up was significantly higher in Group A as compared to that in Group B ($4953.5 ± 3108.5 versus $2764.6 ± 2636.7, respectively, p < 0.01). CONCLUSIONS: In patients presenting with inferior STEMI who received fibrinolytic therapy, a routine invasive strategy with early coronary angiography and intended revascularization, achieved a clinical outcome similar to an ischemia-guided strategy; yet, at a significantly higher cost.

Would coronary collaterals to the infarct-related artery serve as a marker of viability in patients with prior myocardial infarction? A study with trimetazidine-(99m)Tc-sestamibi imaging.

BACKGROUND: Visualization of collateral circulation to the infarct-related artery on coronary angiography was suggested to predict viability in the infarct zone as demonstrated by dobutamine stress echocardiography. METHODS AND MATERIALS: We enrolled 30 consecutive patients referred from our catheterization labs with prior Q-wave myocardial infarction at least 6 months before study enrollment. Patients were classified according to the presence of collaterals to the infarct-related artery into two groups: collateral group with Rentrop Grade 1-3 collaterals, and noncollateral group with Rentrop Grade 0 collaterals. Patients underwent resting (99m)Tc-sestamibi imaging study with the administration of trimetazidine, using the standard technique, within 4 days of coronary angiography. Viability in a specific territory was defined when at least 50% of its individual segments were classified as viable. RESULTS: The visualization of collaterals by coronary angiography was able to predict viability in the territory supplied by the infarct-related artery with a sensitivity of 88.2%; specificity of 53.8%; positive and negative predictive values of 71.4% and 77.8%, respectively; and a diagnostic accuracy of 73.3%. The presence of viability increased progressively, in a statistically significant manner, from Rentrop Grade 0 to Grade 1 and Grade 2 [2 (22.2%), 5 (50%), 10 (91%), respectively, P = .04]. CONCLUSIONS: Visualization of coronary collaterals to the infarct-related artery by coronary angiography may predict with a high sensitivity but a low specificity the presence of viability in the territory supplied by that artery.

Low-dose statin therapy improves endothelial function in type 2 diabetic patients with normal serum total cholesterol: a randomized placebo-controlled study.

The authors sought to explore the effect of low-dose atorvastatin on endothelial function in normocholesterolemic patients with type 2 diabetes mellitus without evidence of coronary disease. Sixty patients with type 2 diabetes mellitus, normal serum cholesterol, and normal exercise test results were enrolled. Initial assessment was performed by measurement of the brachial artery diameter and flow velocity both at baseline and after induced hyperemia. Patients were randomly assigned to receive either atorvastatin 10 mg daily for 4 weeks (atorvastatin group=30 patients) or matched placebo for the same period (placebo group=30 patients). Follow-up assessment of the brachial artery diameter and flow velocity (both baseline and hyperemic) was performed after 4 weeks. Initially, no significant difference was found between the two groups regarding brachial artery diameter or flow velocity, both at baseline and at peak hyperemia (P>.05 for all). At follow-up, there was a significantly higher flow velocity at baseline (P<.05) and a significantly higher percent increase of brachial artery diameter (from baseline to peak hyperemia) in the atorvastatin group (P<.05). In patients with type 2 diabetes mellitus and normal serum cholesterol without evidence of coronary disease, low-dose atorvastatin improves endothelial function.