210Po and 210Pb radioactivity levels in local and imported tobacco used in Palestine and Jordan.

This study aimed to assess the concentrations of 210Po and 210Pb in various tobacco samples from Palestine and Jordan. Cigarette smoking is recognized as a significant contributor to the radiation dose received by individuals, primarily due to the elevated levels of 210Pb and 210Po found in tobacco. The analysis revealed that the average concentrations of 210Po in locally sourced tobacco and cigarette samples in Palestine are 16.8 ± 2.3 mBq/g and 18.5 ± 2.0 mBq/g, with a total average of 17.8 ± 7.4 mBq/g (15.5 mBq/cigarette). Similarly, the average concentrations of 210Pb in these samples are 18.5 ± 2.6 mBq/g and 20.3 ± 2.2 mBq/g, with a total average of 19.6 ± 8.1 mBq/g (17.0 mBq/cigarette). In Jordan, the average concentrations of 210Po in cigarette samples and narghile tobacco are 20.1 ± 2.4 mBq/g and 18.3 ± 4.1 mBq/g, with a total average value of 19.6 ± 9.9 mBq/g (18.0 mBq/cigarette), while the average concentrations of 210Pb are 22.2 ± 2.6 mBq/g and 20.2 ± 4.5 mBq/g, with a total average value of 21.6 ± 10.8 mBq/g (19.9 mBq/cigarette). The annual effective doses resulting from inhalation were calculated for smokers of these samples. The findings revealed that the levels of 210Po and 210Pb radioactivity in certain investigated samples exceeded the results of studies in many countries of the world. The associated effective doses per year from smoking for all brands products in Palestine range from 34.7 µSv/y to 186.5 µSv/y with an average of 109.5 µSv/y, while in Jordan 54.5 µSv/y to 289.1 µSv/y with an average of 130.9 µSv/y.

Bilateral renal angiomyolipoma with left renal artery aneurysm in tuberous sclerosis: case report and literature review.

Introduction and importance: Tuberous sclerosis disorder (TSD) is a rare genetic disease that causes abnormal growths or tumors in various organs of the body. They are usually benign and asymptomatic. However, severe, rapidly growing tuberous sclerosis can be fatal. Renal angiomyolipomas are commonly associated with TSD, which can be further worsened by the presence of aneurysms and put the patient at risk for life-threatening hemorrhage. Case presentation: A 29-year-old female presented to the emergency room complaining of right flank pain with an unknown past medical history of tuberous sclerosis. The patient was suspected to have TSD as she fulfilled one of the major features of TSD required to establish a possible diagnosis. On computed tomography scan imaging, bilateral fat-density nodules were revealed in both kidneys. The largest is 7 cm in the left kidney, located at the upper pole, and was associated with a bleeding aneurysm measuring 4 cm in diameter. While the other fatty nodule was recorded at 6 cm in the right kidney at the lower pole. Clinical discussion: After evaluation, the patient was planned for diagnostic catheterization of the left kidney, through which selective angiography of the left kidney was done, and eventually, selective embolization of the branch supplying the left angiomyolipoma was performed. Conclusion: The authors finally conclude that thorough investigations, including systemic manifestations, must be taken into consideration when suspecting tuberous sclerosis, and a conservative approach must always be prioritized before taking any decision toward invasive approaches.

COVID-19 vaccine acceptance and associated factors among people living with HIV in the Middle East and North Africa region.

Background: Identifying coronavirus disease 2019 (COVID-19) vaccine acceptance and associated factors among people living with HIV (PLHIV) in the Middle East and North Africa region is important to meet the need for broad-scale vaccination against COVID-19. Objectives: To investigate the COVID-19 vaccine acceptance rate and factors among PLHIV in the Middle East and North Africa region. Method: An online cross-sectional survey was conducted among PLHIV currently living in Egypt, Tunisia and Saudi Arabia between March 2021 and August 2021. Results: Of the 540 respondents, 19.3% reported already being vaccinated against COVID-19 (n = 104), 32.0% responded 'definitely yes' (n = 173), and 13.3% responded 'probably yes' (n = 72) for intention to receive a COVID-19 vaccine, with an overall COVID-19 vaccine acceptance rate of 64.6% among PLHIV in the region. The most significant predictors of COVID-19 vaccine acceptance included feeling less worried about COVID-19 transmission post-vaccination (221.0% higher odds), and believing the disease is vaccine-preventable (160.0% higher odds). Reported barriers to COVID-19 vaccine acceptance include concerns about vaccine effectiveness and belief that HIV medications protect against COVID-19 transmission, living in a rural area and reporting less-frequent engagement with HIV care. Nine out of 10 participants reported that the chances of them getting COVID-19 vaccine would increase if given adequate information and if their doctor recommended it. Conclusion: Findings of the study can help researchers, health officials, and other health system actors understand the predictors and barriers to COVID-19 vaccine acceptance reported by PLHIV. This understanding could inform the future planning of interventions tailored to PLHIV.

Emergence of dual antiretroviral therapy as a viable regimen option for the treatment of patients with HIV infection.

Current antiretroviral therapy is not curative. The need for life-long therapy brings with it concerns regarding long-term toxicity and cost. Thus, investigations into simpler regimens with comparable efficacy and improved safety have been undertaken and continue to be conducted. Various 2-drug combinations have been evaluated with variable results. The combinations of dolutegravir plus lamivudine and dolutegravir plus rilpivirine were found to be comparable in efficacy to conventional 3-drug regimens and have now been approved by the United States Food and Drug Administration (FDA) and have entered into clinical practice. Dolutegravir/rilpivirine was approved for the treatment of adults with HIV-1 infection whose virus has been suppressed on a stable regimen for at least 6 months, with no history of treatment failure and no known substitutions associated with resistance to the individual components of the combination. Dolutegravir/lamivudine was approved for the treatment of HIV infection in adults with no antiretroviral treatment history and with no known or suspected resistance to the individual components of the combination.

A pilot study-genetic diversity and population structure of snow leopards of Gilgit-Baltistan, Pakistan, using molecular techniques.

BACKGROUND: The Hindu Kush and Karakoram mountain ranges in Pakistan's northern areas are a natural habitat of the snow leopard (Panthera uncia syn. Uncia uncia) but the ecological studies on this animal are scarce since it is human shy by nature and lives in difficult mountainous tracts. The pilot study is conducted to exploit the genetic diversity and population structure of the snow leopard in this selected natural habitat of the member of the wildcat family in Pakistan. METHOD: About 50 putative scat samples of snow leopard from five localities of Gilgit-Baltistan (Pakistan) along with a control sample of zoo maintained male snow leopard were collected for comparison. Significant quality and quantity of genomic DNA was extracted from scat samples using combined Zhang-phenol-chloroform method and successful amplification of cytochrome c oxidase I gene (190 bp) using mini-barcode primers, seven simple sequence repeats (SSR) markers and Y-linked AMELY gene (200 bp) was done. RESULTS: Cytochrome c oxidase I gene sequencing suggested that 33/50 (66%) scat samples were of snow leopard. AMELY primer suggested that out of 33 amplified samples, 21 (63.63%) scats were from male and 12 (36.36%) from female leopards. Through successful amplification of DNA of 25 out of 33 (75.75%) scat samples using SSR markers, a total of 68 alleles on seven SSR loci were identified, showing low heterozygosity, while high gene flow between population. DISCUSSION: The low gene flow rate among the population results in low genetic diversity causing decreased diversification. This affects the adaptability to climatic changes, thus ultimately resulting in decreased population size of the species.

Dolutegravir plus lamivudine dual therapy - a new option for initial antiretroviral therapy.

The current standard of care for treating HIV infection is the use of three antiretroviral drugs: a combination of two nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) and a third agent from either the integrase strand transfer inhibitor (INSTI), boosted protease inhibitor (PI) or non-nucleoside reverse transcriptase inhibitor (NNRTI) classes. In an effort to minimize the long-term adverse effects and cost of antiretroviral therapy, the use of regimens with fewer drugs in the combination has been under active investigation. To this end, the combination of dolutegravir (DTG) plus lamivudine (3TC), two antiretroviral drugs with a long track record of efficacy and safety in the treatment of HIV infection, is undergoing clinical evaluation in treatment-naive HIV-infected participants. The promising results of the PADDLE study, with 90% of study participants achieving the primary endpoint of HIV-1 RNA lower than 50 copies/mL, were confirmed by the results of ACTG A5353, a phase II, single-arm, open-label study. Subsequently, GEMINI-1 and -2, two phase III, double-blind, noninferiority studies, compared DTG + 3TC to a three-drug regimen of DTG, tenofovir disoproxil fumarate and emtricitabine in 1,433 antiretroviral treatment-naive adults, and demonstrated noninferior efficacy at 48 weeks with no emergence of NRTI or INSTI mutations and a more favorable safety profile. This dual regimen should be avoided in those patients with existing mutations and chronic hepatitis B virus infection. In addition, data in patients with CD4 counts less than 200/mm3 is limited.

Relative Validity and Reproducibility of a Food Frequency Questionnaire to Assess Food Group Intake in Pregnant Jordanian Women.

BACKGROUND: Research on the relationship between maternal diet and pregnancy outcomes requires valid dietary assessment tools in pregnancy. OBJECTIVE: This study aimed to develop and examine the relative validity and reproducibility of a quantitative food frequency questionnaire (FFQ) to estimate food group intake in a sample of pregnant Jordanian women. DESIGN: In this validation study, food group intake from a culturally sensitive quantitative FFQ was compared with food group intake from three 24-hour dietary recalls. PARTICIPANTS AND SETTING: The validation study was conducted from 2015 to 2017 at the maternity clinics in Jordan University Hospital among 131 healthy singleton pregnant Jordanian women. Of these women, 30 also took part in the reproducibility phase, which involved repeated completion of the FFQ in a time frame of 1 month. Pregnant women who had gestational diabetes, preeclampsia, and chronic diseases were excluded. MAIN OUTCOME MEASURES: Relative validity and reproducibility of a 117-item quantitative FFQ used to estimate usual food intake over a period of 1 month. STATISTICAL ANALYSES PERFORMED: Intraclass correlation coefficients and weighted κ statistics were calculated to test the reproducibility between the two administrations of the FFQ. Pearson correlations were estimated to validate the FFQ against 24-hour dietary recalls. Cross-classification and Bland-Altman plots were used to examine the agreement between the two dietary assessment methods. RESULTS: The intraclass correlation coefficients between the two FFQs ranged from 0.24 for legumes to 0.93 for processed meats. A moderate level of agreement was observed between two FFQs. De-attenuated and energy-adjusted correlations ranged from 0.08 for sweets and sugar to 0.93 for sugary drinks. On average, 50.9% and 45.2% of participants were classified by the FFQ and the 24-hour dietary recalls into the same quartile based on their crude and energy-adjusted food group intake, respectively. Bland-Altman plots showed satisfactory agreement between two methods for most food groups. CONCLUSIONS: The FFQ showed moderate reproducibility and good relative validity for most food groups.

Evaluation of the in vitro antioxidant properties of a cod (Gadus morhua) protein hydrolysate and peptide fractions.

Mechanically-deboned cod muscle proteins were sequentially hydrolysed using pepsin and a trypsin+chymotrypsin combination, which was followed by passing the digest through a 1 kDa equipped tangential flow filtration system; the permeate (<1 kDa peptides) was collected as the cod protein hydrolysate (CPH). Reversed-phase high performance liquid chromatography (RP-HPLC) was used to separate the CPH into four peptide fractions (CF1-CF4) and their in vitro antioxidant properties investigated. Results showed that most of the peptide fractions (CF2-CF4) displayed significantly higher (p<0.05) oxygen radical absorbance capacity values (698-942 µM Trolox equivalents, TE/g) and 2,2-diphenyl-1-picrylhydrazyl scavenging activities (17-32%) than those of CPH (613 µM TE/g and 19%, respectively). However, the unfractionated CPH displayed improved capability to scavenge superoxide and hydroxyl radicals as well as significantly higher (p<0.05) ferric iron reduction and chelation of iron than the RP-HPLC peptides. The CPH and peptide fractions displayed a dose-dependent inhibition of linoleic acid oxidation.

Interaction of protamine with gram-negative bacteria membranes: possible alternative mechanisms of internalization in Escherichia coli, Salmonella typhimurium and Pseudomonas aeruginosa.

This study was concerned with the interaction between the cationic antimicrobial peptide, protamine (Ptm) and the cytoplasmic membranes of the gram-negative bacteria Escherichia coli, Salmonella typhimurium and Pseudomonas aeruginosa. The objective of the study was to explain the observed paradox of internalization without permanent disruption of the cell envelope. We carried out Monte Carlo computer simulation of Ptm in an aqueous environment in the presence of ~100 mM NaCl and model membranes consisting of either (65:35) or (75:25) PE:PG molar ratios. The (75:25) model, representative of the gram-negative cytoplasmic membrane, showed that the Ptm center of mass remained at least 7 nm from the membrane surface leading to the prediction that Ptm would not internalize via disruption of the inner membrane. By using immunoelectron microscopy of Ptm-treated cells, we showed that Ptm internalization to the cytoplasm took place rapidly in the presence or absence of the outer envelope. Ultrastructural examination revealed no obvious morphological changes to cells that were treated with subinhibitory or bactericidal levels of Ptm. Reconstituted phospholipid bilayers were constructed and were unperturbed by Ptm treatment over a wide range of concentrations and applied transmembrane voltages. We conclude that in the cases of the cell envelopes of E. coli, S. typhimurium and P. aeruginosa, Ptm internalized by means independent of the phospholipid bilayer, most likely mediated by one or more membrane proteins such as cation-selective barrel-like proteins. Work is currently underway to test this hypothesis.

Evaluation of patterns and appropriate gastro protection in Albanian primary health care users.

Our aim was to assess the prevalence of gastro protection in the Albanian population using non-steroidal anti-inflammatory drugs (NSAIDs). A cross-sectional study, conducted in November-December 2011 in Albania, included 610 NSAIDs users (236 men and 374 women) who visited pharmacies to receive their NSAID medication. A structured questionnaire was administered to all participants including information on age, sex, educational status, pathology being treated with NSAID, presence of gastrointestinal ulcer or related complications, duration of NSAIDs therapy, type of drug used, and gastro protection therapy. Almost all participants (N=599) received NSAIDs to treat rheumatic and/or musculoskeletal disorders. Of these, 475 individuals were on chronic therapy with high daily doses of NSAIDs. Concomitant gastro protective therapy was found in 184 individuals (30 percent of the overall sample). Women and the more educated individuals received more gastro protection than men and the low educated counterparts, respectively (33.4 percent in women vs 25 percent in men; 47 percent in highly educated vs 18 percent in low educated). Appropriate use of gastro protective therapy for NSAID users needs to be promptly implemented in Albania, as its inappropriate use raises ethical and economic concerns. Prescriptions should follow clear guidelines for prevention of gastrointestinal damage following NSAIDs therapy among persons at high risk.

Pressure dependence for the CO quantum yield in the photolysis of acetone at 248 nm: a combined experimental and theoretical study.

The quantum yield of CO in the laser pulse photolysis of acetone at 248 nm and at 298 K in the pressure range 20-900 mbar (N2) has been measured directly using quantitative infrared diode laser absorption of CO. It is found that the quantum yield of CO shows a significant dependence on total pressure with Phi(CO) decreasing with pressure from around 0.45 at 20 mbar to approximately 0.25 at 900 mbar. From a combination of ab initio quantum chemical calculations on the molecular properties of the acetyl (CH3CO) radical and its unimolecular fragmentation as well as the application of statistical (RRKM) and dynamical calculations we show that CO production results from prompt secondary fragmentation (via(2a)) of the internally excited primary CH3CO* photolysis product with an excess energy of approximately 62.8 kJ mol(-1). Hence, our findings are consistent with a consecutive photochemically induced decomposition model, viz. step (1): CH3COCH3+hv--> CH3CO*+ CH3, step (2a): CH3CO*--> CH3+ CO or step (2b) CH3CO*-(+M)--> CH3CO. Formation of CO via a direct and/or concerted channel CH3COCH3+hv--> 2CH(3)+ CO (1') is considered to be unimportant.